结直肠癌5-FU和亚叶酸辅助化疗的评价

目的：评估5－FU和亚叶酸辅助化疗能否提高结直肠癌根治术的疗效。方法：自1988年以来共有225例结直肠癌根治术后应用5－FU利亚叶酸辅助化疗，术后每月一次，连续5天给予亚叶酸150mg和5－FU1．0g／日，6～9个疗程。其中随访满5年可作评估者66例，包括结肠癌38例和直肠癌28例。结果：66例的5年生存率为66．67％，结肠癌为73．68％．直肠癌为57．14％。Dukes—中国改良分期A期的5年生存率结肠癌为100％，直肠癌为80％；B期结肠癌为90．91％．直肠癌为50％；C期结肠癌为60．87％，直肠癌为42．85％，但统计学上结肠癌与直肠癌的差异不显著（P＞0．05）。术后复发率B期结肠癌为18．18％．直肠癌为50％（P＞0．05）；C期结肠癌34．78％．直肠癌71．43％（P＝0．032）。复发病例B期和C期各有1例生存5年以上。结论。提示5－FU和亚叶酸辅助化疗对降低Dukes’C期结肠癌术后复发有肯定疗效。至于对Dukes’B期术后复发车以及对5年生存率的作用，由于病例数偏少，尚不能得出有统计学意义的结论，有待进一步积累病例。

Appraisal of Adjuvant 5-Fluorouracil and Folinic Acid in Colorectal Cancer

Purpose: To evalute the adjuvant 5-FU and folinic acid in colorectal cancer. Methods: 225 cases of colorectal cancer following curative resection had been treated with 5-FU and folinic acid, among them 66 cases have been followed no less than 5 years including 38 cases of colon cancer and 28 cases of rectal cancer. Adjuvant chemotherapy consisted of 5-FU 1000mg and folinic acid 150mg intravenous infusion Dn day 1~5 every month for 6~9 cycles. Results: 44 cases have survived more than 5 years with an overall survival rate of 66. 67%, 73. 68% in colon cancer and 57. 14% in rectal cancer. The 5- year survival rate of colorectal in stage A was 85. 71 %, 100% in colon cancer and 80% in rectal cancer. In Stage B, 80% of the cases survived 5 years, 90. 91% in colon cancer and 50% in rectal cancer. In stage C, 54. 04% of the cases survived 5 years, 60. 87% in colon cancer and 42. 85% in rectal cancer. No significant difference in survival rate was found between colon cancer and rectal caneer. Recurrence rate in stage B of colon cancer was 18. 18% and that of rectal cancer was 50%; in stage C of colon cancer was 34. 78% and that of rectal cancer was 71. 43% (P=0.032). Conclusions: The combination of 5-FU and folinic acid is an useful and valuable adjuvant chemotherapy for colorectal cancer. Its effect was better in colon than in rectal especially in stage C lesions.