결장암 환자에서 근치적 수술후 5- Fluorouracil과 leucovorin 보조 항암요법의 용량 및 용량 강도에 따른 효과

Abstract

Background : In patients with stage C colon cancer, surgery followed by adjuvant chemotherapy with 5- fluorouracil (5- FU)/ leucovorin (LV) is considered to be the standard treatment. However, the objects of adjuvant therapy and the duration of treatment are still matters of controversy. We investigated the effect of dose related factor(delivered total dose of 5- FU per body square meter, actual dose intensity and relative dose intensity) of the adjuvant 5- FU/ leucovorin regimen on survival in colon cancer. Methods : Of the colon cancer patients with Duke' s B2 and C stage diseases treated with curative resection from December, 1990 to December, 1996, 139 patients treated with 5- FU/LV as an adjuvant chemotherapy were evaluated. The delivered total dose of 5- FU per body square meter, actual dose intensity and relative dose intensity were obtained. The patients were divided into two groups according to the median value of each factor and the survival rates were compared. Results : The total dose of 5- FU administrated per body square meter had a significant effect on the 5- year disease free and overall survival in stage B2 and C colon cancer patients(B2; p=0.025, p=0.045, respectively, C; p=0.011, p=0.0002, respectively). But survival was not affected by the dose intensity. Multivariate analysis demonstrated that only the total dose of 5- FU administrated per body surface area affected the 5- year disease free and overall survival(p=0.0016, p=0.0007, respectively). Conclus ion : It can be concluded that the total dose of 5- FU administered is more important than the DI in adjuvant chemotherapy of colon cancer and the total dose of 5- FU had a significant effect on the survival rate in colon cancer patients. To confirm the total dose effect of 5- FU on survival in this study, multi- institutional, prospective randomized studies should be carried out.(Korean J Med 59:290- 299, 2000)