Abstract：
The optimal timing of adjuvant chemotherapy (AC) in non-metastatic colon cancer is poorly defined. Delays in AC result in decreased survival. Effective cytotoxic treatments should be considered during the perioperative phase of care. The immediate adjuvant chemotherapy (IAC) concept intends to capitalize on the therapeutic benefits that can be achieved in the perioperative period. We aim to demonstrate that IAC is safe and tolerable.
Microsatellite stable invasive adenocarcinomas were treated with intravenous Leucovorin 20 mg/m2 and single dose of 5-Flurouracil 400mg/m2 at the time of surgery. High-risk stage II and stage III received the first dose of standard AC at 14 days after surgery. Serial measurements of blood-based biomarkers were measured. Quality of life (QOL) was measured using EORTC QLQ-C30.
Of the 20 patients recruited, 40% had final pathology of stage III, 40% stage II and 20% stage I. All patients received intra-operative chemotherapy with no associated morbidity. Median length of stay was 2 days (range of 2-4). There was no intraoperative morbidity with 5% (N = 1) grade 3 complication. AC was administered to 65% of patients. The median time to AC was 14 days (range 14-36). Overall quality of life and health scores were similar before surgery and at 30-day postoperatively (P < .05).
A protocol based on IAC starting at the time of surgical resection was found to be safe and feasible with no adverse effects on surgical morbidity or quality of life. Further prospective studies are needed to explore the oncologic benefit of this novel systemic treatment approach.
Microsatellite stable invasive adenocarcinomas were treated with intravenous Leucovorin 20 mg/m2 and single dose of 5-Flurouracil 400mg/m2 at the time of surgery. High-risk stage II and stage III received the first dose of standard AC at 14 days after surgery. Serial measurements of blood-based biomarkers were measured. Quality of life (QOL) was measured using EORTC QLQ-C30.
Of the 20 patients recruited, 40% had final pathology of stage III, 40% stage II and 20% stage I. All patients received intra-operative chemotherapy with no associated morbidity. Median length of stay was 2 days (range of 2-4). There was no intraoperative morbidity with 5% (N = 1) grade 3 complication. AC was administered to 65% of patients. The median time to AC was 14 days (range 14-36). Overall quality of life and health scores were similar before surgery and at 30-day postoperatively (P < .05).
A protocol based on IAC starting at the time of surgical resection was found to be safe and feasible with no adverse effects on surgical morbidity or quality of life. Further prospective studies are needed to explore the oncologic benefit of this novel systemic treatment approach.
摘要：
非转移性结肠癌辅助化疗（AC）的最佳时机尚不明确。AC的延迟导致存活率降低。在围手术期护理阶段应考虑有效的细胞毒性治疗。立即辅助化疗（IAC）的概念旨在利用围手术期可以实现的治疗益处。我们的目标是证明IAC是安全和可容忍的。
在手术时，用静脉注射亚叶酸钙20mg/m2和单剂量5-氟尿嘧啶400mg/m2治疗微卫星稳定侵袭性腺癌。高危II期和III期在手术后14天接受第一剂标准AC。测量基于血液的生物标志物的连续测量。使用EORTCQLQ-C30测量生活质量(QOL)。
在招募的20名患者中,40%有III期最终病理，II期40％和I期20％所有患者均接受术中化疗，无相关发病率。中位住院时间为2天（范围为2-4天）。没有术中发病率和5％（N=1）3级并发症。对65%的患者施用AC。到达AC的中位时间为14天(范围14-36)。手术前和术后30天的总体生活质量和健康评分相似（P<0.05）。
从手术切除时开始的基于IAC的方案被发现是安全可行的，对手术发病率或生活质量没有不利影响。需要进一步的前瞻性研究来探索这种新型全身治疗方法的肿瘤学益处。
在手术时，用静脉注射亚叶酸钙20mg/m2和单剂量5-氟尿嘧啶400mg/m2治疗微卫星稳定侵袭性腺癌。高危II期和III期在手术后14天接受第一剂标准AC。测量基于血液的生物标志物的连续测量。使用EORTCQLQ-C30测量生活质量(QOL)。
在招募的20名患者中,40%有III期最终病理，II期40％和I期20％所有患者均接受术中化疗，无相关发病率。中位住院时间为2天（范围为2-4天）。没有术中发病率和5％（N=1）3级并发症。对65%的患者施用AC。到达AC的中位时间为14天(范围14-36)。手术前和术后30天的总体生活质量和健康评分相似（P<0.05）。
从手术切除时开始的基于IAC的方案被发现是安全可行的，对手术发病率或生活质量没有不利影响。需要进一步的前瞻性研究来探索这种新型全身治疗方法的肿瘤学益处。
