POSTSURGICAL SEQUENTIAL METHOTREXATE, FLUOROURACIL, AND LEUCOVORIN FOR ADVANCED COLORECTAL-CARCINOMA - A PRELIMINARY-STUDY

Background and Objectives: The present study compared the effects of s equential methotrexate and fluorouracil followed by leucovorin rescue (MFL), as an adjuvant chemotherapy versus a combination of tegafur (UF T) and mitomycin C (MMC), on patient survival and recurrence after sur gery for colorectal carcinoma. Methods: Between January 1990 and Decem ber 1995, a total of 46 patients with advanced colorectal cancer were treated postsurgically by adjuvant chemotherapy using MFL or UFT-MMC. Surgical treatment was performed according to standardized procedures for radical resection of colorectal cancer. The patients were stratifi ed into two groups after surgery. The MFL regimen consisted of MTX (10 0 mg/m(2)) and 5-FU (600 mg/m(2)) at hour 24, followed by leucovorin r escue. The UFT-MMC regimen consisted of MMC (12 mg/m(2)) intraoperativ ely and MMC (6 mg/m(2)) ever other week after surgery for 2 months and oral UFT (375 mg/m(2)/day), a combination of tegafur and uracil in a molar ratio of 1:4, was continued for 3 years or longer depending on t he patients tolerance. Results: The overall survival rates after surge ry was significantly (P < 0.05) higher in the MFL than the UFT-MMC gro up. Recurrence rates were significantly lower in the MFL than the UFT- MMC Group, especially for liver recurrence. Disease-free survival was significantly (P < 0.05) higher in the MFL than the UFT-MMC group. Con clusions: The present results demonstrated the superiority of MFL ther apy for improving postsurgical survival in patients with advanced colo rectal cancer, in particular for those patients with a high risk of re currence following potential curative resection. (C) 1997 Wiley-Liss, Inc.