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Adjuvant chemotherapy in colorectal cancer: a joint analysis of randomised trials by the Nordic Gastrointestinal Tumour Adjuvant Therapy Group.

https://arctichealth.org/en/permalink/ahliterature16598
Source
Acta Oncol. 2005;44(8):904-12
Publication Type
Article
Date
2005
Author
Bengt Glimelius
Olav Dahl
Björn Cedermark
Anders Jakobsen
Søren M Bentzen
Hans Starkhammar
Henrik Grönberg
Ragnar Hultborn
Maria Albertsson
Lars Påhlman
Kjell-Magne Tveit
Author Affiliation
Department of Oncology, Radiology and Clinical Immunology, University Hospital, Uppsala, Sweden. bengt.glimelius@onkologi.uu.se
Source
Acta Oncol. 2005;44(8):904-12
Date
2005
Language
English
Publication Type
Article
Abstract
Due to uncertainties regarding clinically meaningful gains from adjuvant chemotherapy after colorectal cancer surgery, several Nordic Groups in the early 1990s initiated randomised trials to prove or reject such gains. This report gives the joint analyses after a minimum 5-year follow-up. Between October 1991 and December 1997, 2 224 patients under 76 years of age with colorectal cancer stages II and III were randomised to surgery alone (n = 1 121) or adjuvant chemotherapy (n = 1 103) which varied between trials (5FU/levamisole for 12 months, n = 444; 5FU/leucovorin for 4-5 months according to either a modified Mayo Clinic schedule (n = 262) or the Nordic schedule (n = 397). Some centres also randomised patients treated with 5FU/leucovorin to+/-levamisole). A total of 812 patients had colon cancer stage II, 708 colon cancer stage III, 323 rectal cancer stage II and 368 rectal cancer stage III. All analyses were according to intention-to-treat. No statistically significant difference in overall survival, stratified for country or region, could be found in any group of patients according to stage or site. In colon cancer stage III, an absolute difference of 7% (p = 0.15), favouring chemotherapy, was seen. The present analyses corroborate a small but clinically meaningful survival gain from adjuvant chemotherapy in colon cancer stage III, but not in the other presentations.
PubMed ID
16332600 View in PubMed
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