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JNCI:缺陷错配修复结肠癌III患者采用氟尿嘧啶联合奥沙利铂辅助化疗有效

2016-02-04 fsy 译 MedSci原创

有报告称缺陷错配修复(dMMR)结肠癌(CC)对于5-氟尿嘧啶(5FU)辅助化疗是有抗性的,然而初步数据表明患者对于奥沙利铂具有化疗敏感性。研究人员评估了氟尿嘧啶类药物对于dMMR CC患者使用和不使用奥沙利铂的情况下的疗效。这个多中心回顾性研究包括在2000和2011年之间所有接受根治性手术切除的II期或III dMMR CC患者。采用Cox模型分析预后因素,风险比(HRs)和95%可信区间(C

有报告称错配修复功能缺陷(dMMR)的结肠癌(CC)患者对于5-氟尿嘧啶(5FU)辅助化疗是有抗性的,然而初步数据表明患者对于奥沙利铂是有化疗敏感性的。研究人员评估了氟尿嘧啶类药物对于dMMR CC患者使用和不使用奥沙利铂的情况下的疗效。

这个多中心回顾性研究包括在2000和2011年间的所有接受根治性手术切除的II期或III dMMR CC患者。采用Cox模型分析对预后因素、风险比(HRs)和95%可信区间(CIs)进行了计算。所有统计检验均为双侧。

共有433dMMR CC患者(56.8%II期,43.2%Ⅲ期)。平均随访时间为47.0个月。患者接受单纯手术(N=263)或手术加包含氟尿尿嘧的辅助化疗加入(n=119)或不加入(n=51)奥沙利铂。16.7%的II期患者和69.0%的Ⅲ期CC患者进行辅助化疗管理。与单纯手术相比,辅助奥沙利铂化疗的多变量分析中提高了无病生存率(DFS)(HR=0.35,95%CI=0.19〜0.65,P<0.001),而辅佐单独氟嘧啶的结果则相反(HR=0.73 ,95%CI=0.36〜1.49,P=0.38)。在亚组分析中,多变量分析显示奥沙利铂化疗的DFS好处只有在III阶段的患者有统计学意义(HR=0.41,95%CI=0.19〜0.87,P=0.02)。

这项研究支持了dMMR CC III阶段患者采用氟尿嘧啶联合奥沙利铂辅助化疗。

原始出处:

Tougeron D, Mouillet G, Trouilloud I,et al.Efficacy of Adjuvant Chemotherapy in Colon Cancer With Microsatellite Instability,J Natl Cancer Inst,2016.2.1

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