Efficacy of a continuous venous infusion of fluorouracil and daily divided dose cisplatin as adjuvant therapy in resectable colorectal cancer: A prospective randomized trial

• Published in: Surgery today (Tokyo, Japan) Vol. 38; no. 7; pp. 623 - 632
• Main Authors: Hata, Fumitake, Sasaki, Kazuaki, Hirata, Koichi, Yamamitsu, Susumu, Shirasaka, Tetsuhiko
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.07.2008
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy, Adjuvant; Cisplatin - administration & dosage; Cisplatin - adverse effects; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - mortality; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Drug Administration Schedule; Female; Fluorouracil - administration & dosage; Fluorouracil - adverse effects; Follow-Up Studies; Humans; Infusions, Intravenous; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Original Article; Prospective Studies; Surgery; Surgical Oncology; Survival Rate; Treatment Outcome; Young Adult; Adjuvant chemotherapy; Prospective randomized trial; Cisplatin; Colorectal cancer; Fluorouracil
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-007-3689-z

Purpose Daily divided dose cisplatin (DDD-P) is used as an efficient modulator of fluorouracil (5-FU), as is leucovorin (LV). We performed a randomized trial to compare the efficacy 5-FU plus DDD-P (DDD-FP) therapy with 5-FU alone in resected colorectal cancer as the adjuvant therapy. Methods One hundred and eighty-eight stage II or III colorectal cancer patients were enrolled. Patients were randomly assigned to receive DDD-FP (5-FU, 320 mg/ m 2 , daily for 21 days; CDDP, 3.5 mg/m 2 daily for 21 days) followed by oral 5-FU (200 mg/body daily for 2 years) (DDD-FP arm) or oral 5-FU therapy (200 mg/ body daily for 2 years) exclusively (oral 5-FU arm). Results The 5-year disease-free survival (DFS) rates and the overall survival (OS) rates indicated no significant difference between the two arms. By stratified analysis, in the colon cancer patients, the DFS and the OS for the DDD-FP arm were significantly increased: 93.5% and 95.7% in the DDD-FP arm as compared with 76.9% and 82.2% in the oral 5-FU arm ( P = 0.024 and P = 0.038). Regarding adverse effects, grade 3–4 toxicities were not significant in two arms. Conclusions DDD-FP followed by oral 5-FU therapy suggested a feasible regimen for patients with resected colon cancer as the adjuvant therapy.