Oral Tegafur-uracil Modulated with Folinic Acid in the Treatment of Colorectal Cancer

使用口服Tegafur-uracil合併Folinic acid治療大腸直腸癌

蔣鋒帆(Feng-Fan Chiang) ； 王輝明(Hwei-Ming Wang) ； 陳周斌(Joe-Bin Chen) ； 陳周誠(Chou-Chen Chen) ； 馬秀峰(Hsiu-Feng Ma) ； 趙德馨(Teshin Chao)

《中華民國大腸直腸外科醫學會雜誌》 16卷4期 (2005/12) Pp. 112-120

https://doi.org/10.6312/SCRSTW.2005.16(4).09416

摘要

目的　雖然使用口服tegafur-uracil合併folinic acid治療大腸直腸癌有著易於服用與良好耐受性的優點，但其服用方式與臨床的結果並未被探討。本文是希望能對台灣大腸直腸癌患者使用口服化療藥物tegafur-uracil的療效與毒副作用評估，並探討相關文獻。
方法　從2001年4月至2005年3月，共有142位未做過化療，不願靜脈注射化療的第Ⅱ、Ⅲ期大腸直腸癌患者使用口服tegafur-uracil和folinic acid作為術後輔助治療。其中有79為男性與63位女性，平均62.3歲（標準差13.2歲）。其復發時間與毒副作用與同時期作靜脈注射5FU與folinic acid之75位病患作比較。（對照組：44為男性，31位女性，平均62.2歲，標準差13.2歲）。
結果　當把對照組當成1時，整體的危險性為0.667（95%信賴區間：0.383~1.160）。使用口服tegafur-uracil組的復發危險度降低可見於第三期直腸癌（降低0.092）與大腸癌（降低0.391）。其中位復發時間48.23(上標 +)個月。
結論　口服tegafur-uracil合併使用folinic acid相對於靜脈注射flurouracil與leucovorin為基礎的輔助化療不僅有相當的療效且有較小的毒性，可提供多方面化療原則的一個很好的選擇。因此整體上對大腸直腸癌病人是有益的。

關鍵字

友復 ； 大腸直腸癌

並列摘要

Purpose. While treating colorectal cancer with oral tegafur-uracil (UFT) plus folinic acid is attractive because of its ease of administration and good tolerability, little is known about the clinical results. This study was intended as to investigate the efficacy and toxicities of this regimen in patients with colorectal cancer in Taiwan. The related literature was also reviewed.
Methods. A total of 142 chemo-naïve patients with stage Ⅱ or stage Ⅲ colorectal cancer between April 2001 and March 2005 were retrospectively analysed. These patients hesitated about infusional 5-FU and were treated with oral UFT and folinic acid as adjuvant chemotherapy. There were 79 males and 63 females; mean age 62.3±13.2 years. There were 75 patients treated with infusional 5-fluorouracil and leucovorin at the same period, which included 44 males and 31 females with mean age 62.2±13.2 years. The time-to-disease recurrence and adverse effects of both groups were analyzed.
Results. The overall hazard ratio was 0.667 (95% CI, 0.383-1.160) when the infusional chemotherapy group was taken as 1. The benefits of oral tegafur-uracil were seen both in rectal (hazard ratio reduction 0.092) and colon cancers (hazard ratio reduction 0.391) in patients with stage Ⅲ disease. The median interval of time-to-disease recurrence was 48.23 months.
Conclusions. This study demonstrates that oral tegafur-uracil modulated with leucovorin as an adjuvant chemotherapy in stage Ⅲ colorectal carcinoma had comparative efficacy and minimal toxicity to the infusional 5FU and leucovorin. It can not only be an alternative to intravenous fluorouracilbased chemotherapy but also a good choice for applying a multi-targeted chemotherapy protocol, thus increasing the overall benefit to patients with colorectal cancer.

並列關鍵字

Tegafur-uracil ； Colorectal cancer