Randomised comparison of combination chemotherapy plus supportive care with supportive care alone in patients with metastatic colorectal cancer.
OBJECTIVE
To compare the length of survival and quality of life in patients given combination chemotherapy in addition to supportive care and in patients given only supportive care.


METHODS
Randomised study.


METHODS
Gastrointestinal oncology departments.


METHODS
40 previously untreated patients with histologically confirmed, measurable colorectal cancer that was locally recurrent or metastatic.


METHODS
Patients were allocated randomly to receive chemotherapy or only supportive care in a ratio of 2:1 according to performance status, metastatic disease of the liver, and weight loss in the six months before entering the study. Chemotherapy consisted of four week cycles of intravenous leucovorin (200 mg/m2/day) followed by 5-fluorouracil (550 mg/m2/day) and cisplatin (20 mg/m2/day), each drug being given on the first four days of the cycle.


METHODS
Length of survival and quality of life score with an optimised functional living index-cancer scale.


RESULTS
Overall survival was significantly longer for patients given chemotherapy (11.0 months) than for those receiving supportive care alone (5.0 months; p = 0.006). Despite common association of chemotherapy with mild to moderate gastrointestinal symptoms, there was no significant difference between the two groups in global or subgroup quality of life scores. In patients with abnormal scores before treatment, quality of life seemed better in the chemotherapy arm.


CONCLUSIONS
In this sample of patients with disseminated colorectal cancer the chemotherapy regimen was an effective form of palliative treatment.
Scheithauer
W
W
Department of Internal Medicine I, Vienna University Medical School, Austria.
Rosen
H
H
Kornek
G V
GV
Sebesta
C
C
Depisch
D
D
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000628:therapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000628:therapy; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011379:Prognosis; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary / Q000628:therapy; D012944:Social Support
D002945:Cisplatin; D002955:Leucovorin; D005472:Fluorouracil