[Chemotherapy for colorectal carcinoma].

Hiroyuki Uetake¹, Tetsuro Higuchi, Masayuki Enomoto

¹Department of Digestive Surgery, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

Gan to Kagaku Ryoho. Cancer & Chemotherapy

|December 4, 2003

Summary

First-line advanced colorectal cancer (CRC) treatment often uses 5-fluorouracil (5-FU) plus leucovorin (LV). Oral UFT and leucovorin (LV) show comparable efficacy with fewer side effects, while intrahepatic arterial infusion (IHA) requires further study for survival benefits.

Area of Science:

Oncology
Gastroenterology
Medical treatment

Background:

Advanced colorectal cancer (CRC) treatment relies heavily on intravenous 5-fluorouracil (5-FU) plus leucovorin (LV) as first-line therapy.
Second-line treatment commonly involves CPT-11.
Intrahepatic arterial infusion (IHA) shows promise for liver metastases, but survival data are pending.

Purpose of the Study:

To evaluate the efficacy and safety of oral UFT and leucovorin (LV) combination therapy for advanced colorectal cancer (CRC).
To assess the role of intrahepatic arterial infusion (IHA) in treating liver metastasis in CRC patients.
To determine the survival benefit of adjuvant 5-fluorouracil (5-FU) and leucovorin (LV) after resection of Dukes' C CRC.

Main Methods:

Review of randomized prospective studies comparing oral UFT/LV with standard chemotherapy.
Analysis of response rates for intrahepatic arterial infusion (IHA) in liver metastasis.
Evaluation of prospective studies on adjuvant 5-fluorouracil (5-FU) and leucovorin (LV) post-curative resection.

Main Results:

Oral UFT and leucovorin (LV) demonstrate equal efficacy to standard regimens with improved tolerability.
Intrahepatic arterial infusion (IHA) exhibits a high response rate for liver metastases.
Six months of 5-fluorouracil (5-FU) and leucovorin (LV) post-adjuvant resection improves survival in Dukes' C CRC.

Conclusions:

Oral UFT/LV offers a convenient and effective alternative for advanced colorectal cancer (CRC).
Intrahepatic arterial infusion (IHA) warrants further investigation for survival benefits in liver metastasis.
Adjuvant 5-fluorouracil (5-FU) and leucovorin (LV) are beneficial after curative resection for Dukes' C CRC.

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