Neoadjuvant Modified Infusional Fluorouracil, Leucovorin, and Oxaliplatin With or Without Radiation Versus Fluorouracil Plus Radiation for Locally Advanced Rectal Cancer: Updated Results of the FOWARC Study After a Median Follow-Up of 10 Years.

IF 42.1 1区 医学 Q1 ONCOLOGY
Journal of Clinical Oncology Pub Date : 2025-02-20 Epub Date: 2024-12-13 DOI:10.1200/JCO-24-01676
Jianwei Zhang, Pan Chi, Lishuo Shi, Long Cui, Jinbo Gao, Wanglin Li, Hongbo Wei, Longqing Cheng, Zonghai Huang, Guangfu Cai, Ren Zhao, Zhongcheng Huang, Hongfeng Zhou, Yisheng Wei, Hao Zhang, Jian Zheng, Yan Huang, Yue Cai, Zhiyang Zhou, Liang Kang, Meijin Huang, Xiaojian Wu, Junsheng Peng, Donglin Ren, Ping Lan, Jianping Wang, Yanhong Deng
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引用次数: 0

Abstract

We present 10-year results of the phase Ⅲ FOWARC trial, which evaluated the efficacy of modified infusional fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) with or without radiation compared with fluorouracil with radiation in patients with locally advanced rectal cancer. A total of 495 patients age 18-75 years with stage Ⅱ-Ⅲ rectal cancer were randomly assigned to three treatment arms: fluorouracil plus radiotherapy, mFOLFOX6 plus radiotherapy, or mFOLFOX6 alone, followed by surgery and adjuvant chemotherapy. With a median follow-up of 10 years, the 10-year disease-free survival (DFS) rates were 52.5%, 62.6%, and 60.5%, respectively (P = .56). The 10-year locoregional recurrence (LR) rates were 10.8%, 8.0%, and 9.6% (P = .57), and the 10-year overall survival (OS) rates were 65.9%, 72.3%, and 73.4% (P = .90). Subgroup analysis identified ypTNM stage as a significant prognostic factor for DFS, LR, and OS (P < .0001, P < .006, P < .0001, respectively). Patients achieving pathologic complete response had 10-year DFS, LR, and OS rates of 84.3%, 3.0%, and 92.4%, respectively. No significant difference was observed in long-term survival outcome between mFOLFOX6 with and without radiation and fluorouracil plus radiation. These results demonstrate that neoadjuvant mFOLFOX6 chemotherapy can be considered as a therapeutic option in LARC.

新辅助改良输注氟尿嘧啶、亮菌素和奥沙利铂联合或不联合放疗与氟尿嘧啶加放疗治疗局部晚期直肠癌:中位随访 10 年后的 FOWARC 研究最新结果。
我们介绍了ⅢFOWARC期试验的10年结果,该试验评估了改良输注氟尿嘧啶、亚叶酸钙和奥沙利铂(mFOLFOX6)在局部晚期直肠癌患者中与氟尿嘧啶加放疗相比,在放疗或不放疗的情况下的疗效。495例年龄18-75岁Ⅱ-Ⅲ期直肠癌患者被随机分配到三个治疗组:氟尿嘧啶加放疗、mFOLFOX6加放疗或mFOLFOX6单独治疗,然后进行手术和辅助化疗。中位随访10年,10年无病生存率(DFS)分别为52.5%、62.6%和60.5% (P = 0.56)。10年局部区域复发率(LR)分别为10.8%、8.0%和9.6% (P = 0.57), 10年总生存率(OS)分别为65.9%、72.3%和73.4% (P = 0.90)。亚组分析发现,ypTNM分期是DFS、LR和OS的重要预后因素(P < 0.0001, P < 0.006, P < 0.0001)。达到病理完全缓解的患者的10年DFS、LR和OS率分别为84.3%、3.0%和92.4%。mFOLFOX6接受和不接受放射治疗与氟尿嘧啶加放射治疗的长期生存结果无显著差异。这些结果表明,新辅助mFOLFOX6化疗可以被认为是LARC的治疗选择。
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来源期刊
Journal of Clinical Oncology
Journal of Clinical Oncology 医学-肿瘤学
CiteScore
41.20
自引率
2.20%
发文量
8215
审稿时长
2 months
期刊介绍: The Journal of Clinical Oncology serves its readers as the single most credible, authoritative resource for disseminating significant clinical oncology research. In print and in electronic format, JCO strives to publish the highest quality articles dedicated to clinical research. Original Reports remain the focus of JCO, but this scientific communication is enhanced by appropriately selected Editorials, Commentaries, Reviews, and other work that relate to the care of patients with cancer.
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