Chimiotherapie adjuvante apres chirurgie dans les carcinomes colo-rectaux non metastatiques [resultats de 2 ans. propos de 52 cas]

ABSTRACT

Purpose: Adjuvant 5-FU based chemotherapy is actually the recommended adjuvant post- operative treatment for stages B2 and C colo-rectal cancers. We report our experience and analyze the therapeutic preliminary results. patients and methods: from December 1989 to august 1996, we collect 52 patients [25 M/27 F] with surgically resected stages B2 [14 pts] and C [38 pts] carcinoma of the colon [39 pts] or rectum [13 pts]. The potients receive adjuvant chemotherapy with 5Flurouracil- levamisole for 1 year or 5Fluoroouracil-Folinic acid for 6 cycles. mean age is 46.7 years [16 to 77] and average delay to diagnosis 6.5 months. we use the Funlevamisole protocol [1 year duration] for 19 patients which 58% receive the totaliy of treatment, 5FU alone [6 cycles] has been used for 7 patients who receive a mean number of 5.2 cycels with a compliance of 64% the resting 31 patients receive the FU-Fol protocal [6 cycles] with a total of 158 cycles administered representing a mean number of 5.2 cycles/ patient with a compliance of 64% Secondary side-effects are essentially digestive represented by diarrhea and/ or abdominal pain or less frequently neutropenia or mucositis. With a median follow-up of respectively 25.8 months [2 to 102], 2 and 3 year actuarial global survival for the whole population is 60 and 30%. According to Dukes stage the survival is respectively 78 and 40% for stages B2 versus 63 and 30% for stages C. the group treated with SFU-Levamisole treatment have a 83 and 57% 2 and 3 year actuarial global survival versus 80 and 33% for the group treated with SFU-Folinic acid- Despite a shorter median follow-up we observe a positive impact of adjuvant chemotheragy on the survival of B2 and C treated patients. However many of our patients have been operated with bulky and/or perfored or infected tumors, factors that reduce the chances of a complete resection