Recurrence and 5-FU sensitivity of stage III/Dukes' C colorectal cancer with occult neoplastic cells in lymph node sinuses

Alternating hepatic arterial infusion and systemic chemotherapy for stage IV colorectal cancer with synchronous liver metastasis

“…Therefore, systemic chemotherapy is essential irrespective of whether or not patients have pulmonary metastases, considering that liver metastases may also release ONCs that could reach the lungs to cause fatal metastatic lesions (20). Previous examination of the sensitivity of ONCs to systemic 5-FU + LV therapy showed that few tumor cells displayed a high sensitivity (high TS/low DPD expression) in the recurrence group, suggesting that the chemotherapy regimens used currently might be inadequate (32)(33)(34). It has been reported that combination chemotherapy with CPT-11 and L-OHP, drugs which are more popular in Western countries than Japan, is clinically and pharmacokinetically more effective than 5-FU + LV therapy (27)(28)(29)(30).…”

Efficacy of 5-FU/LV plus CPT-11 as first-line adjuvant chemotherapy for stage IIIa colorectal cancer

“…According to some reports, addition of CPT-11 or L-OHP to 5-FU/LV therapy has nearly equivalent of anticancer drug sensitivity. In the first-line setting following curative resection, CPT-11 is a more reasonable choice than L-OHP because of a low incidence of neurological adverse events such as neuropathy and paresthesia and because it is less costly (11,12,20). It would seem advisable to retain L-OHP as a second-line treatment for distant metastasis/recurrence.…”

“…Accordingly, the importance of postoperative adjuvant chemotherapy presumably lies in achieving the eradication of residual free cancer cells, which circulate around the body in the perioperative period (10)(11)(12) (10)(11)(12). Although the dosage and administration regimen also have an important influence on the activity of drugs, the most important factor is tumor sensitivity and the activity of any additional drugs.…”

Clinical comparison of QOL and adverse events during postoperative adjuvant chemotherapy in outpatients with node-positive colorectal cancer or gastric cancer

“…Investigation of tumor sensitivity to 5-FU/LV therapy at the time of systemic dispersion of circulating ONC clusters that may develop into metastases has revealed that few tumors show a high sensitivity represented by a high-TS/low-DPD level, suggesting that this regimen might be too weak (39,40). To increase the potency of this regimen, addition of CPT-11 or L-OHP which are more popular in the West than in Japan could be effective with respect to interactions and potentiation by modulation (14 -16).…”