title: [Neo-adjuvant chemotherapy with carmofur for colorectal cancer--a multi-institutional randomized controlled study].
abstract: The efficacy and safety of preoperative chemotherapy with carmofur (HCFU) for colorectal cancer were evaluated in a randomized controlled study involving 63 institutes in the Kanto area. Patients aged 75 or younger with Dukes' B or C colorectal cancer were eligible if curative surgery was expected. In the end, 326 were eligible from 405 consecutive colorectal cancer patients. Patients in both the control (n = 162) and the new treatment group (n = 164) were given intravenous mitomycin C (MMC) 6 mg/m2 on day 0 and 7 after surgery and HCFU 300 mg/day orally from day 14 for a year. Patients in the new treatment group were also given oral HCFU for 14 days or more prior to surgery. All 326 patients were followed for 5 years or longer. Five-year overall and disease-free survival rates were not significantly different between the two groups (75.4% and 71.6% for the control, and 71.8% and 71.5% for the study group, respectively). In the subset analysis, neither cancer site nor nodal status affected the differences in overall- and disease-free survival rates between the groups. The present findings show no additional efficacy of preoperative chemotherapy with HCFU in survival from advanced colorectal cancer. Further investigations in terms of patient selection, treatment regimen, combined use of radiotherapy, and other factors would be required to determine the significance of preoperative chemotherapy against advanced colorectal cancer.
authors.affiliation: Dept. of Surgery, Tochigi Cancer Center.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kotake
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Koyama
authors.forename: Shigemitsu
authors.initials: S
authors.lastname: Shida
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tajima
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishikawa
authors.forename: Kyotaro
authors.initials: K
authors.lastname: Kanazawa
authors.forename: Michio
authors.initials: M
authors.lastname: Miyata
authors.forename: Yukio
authors.initials: Y
authors.lastname: Nagamachi
authors.forename: Yoji
authors.initials: Y
authors.lastname: Iwasaki
authors.forename: Ryozo
authors.initials: R
authors.lastname: Omoto
authors.forename: Shoetsu
authors.initials: S
authors.lastname: Tamakuma
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitajima
authors.forename: Susumu
authors.initials: S
authors.lastname: Kodaira
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011300:Preoperative Care; D011446:Prospective Studies; D015996:Survival Rate
chemical_list: D016685:Mitomycin; C017367:carmofur; D005472:Fluorouracil