Chemotherapy improves outcome in low risk colorectal cancer
A ten-year study of bowel cancer treatment has found that chemotherapy reduces the risk of recurrence and death even for patients with early stage disease.
The ‘QUASAR’ trial led by the University of Birmingham Clinical Trials Unit has published findings in The Lancet, which indicate that wider use of chemotherapy could prevent many hundreds of deaths in the UK and thousands more worldwide.
Colorectal cancer is the second most common malignant disease in developed countries, with 1 million new cases and 500 000 deaths worldwide every year.
3239 patients with bowel cancer from 150 centres in 19 countries took part in the QUASAR clinical trial, receiving either fluorouracil and folinic acid chemotherapy after surgery or surgery alone.
Professor Richard Gray, Director of the University of Birmingham Clinical Trials Unit and one of the organisers of the study, explained: “ We already know that giving chemotherapy after surgery for bowel cancer improves survival for patients whose cancer has spread to the adjacent lymph nodes (stage III bowel cancer). For these patients chemotherapy is the standard treatment.
But, for the 25% of patients who have bowel cancer that is detected before it has spread to the adjacent lymph nodes (stage II disease) there has been uncertainty whether chemotherapy is beneficial.
The QUASAR (QUick And Simple And Reliable) study was designed to answer this question.”
The results of the QUASAR study demonstrate that chemotherapy does improve outcome in stage II bowel cancer. There were 22% fewer recurrences and 18% fewer deaths among patients receiving chemotherapy compared to patients receiving surgery alone.
Professor Gray adds: “Because the study was so big, we can be confident that these differences are real. Although the survival improvements are not large, because stage II bowel cancer is so common, wider use of chemotherapy could prevent hundreds of deaths in the UK and many thousands more worldwide.”
Notes: The QUASAR trial was funded by the UK Medical Research Council and Cancer Research UK.
Richard Gray is Professor of Medical Statistics and Director of the Birmingham Clinical Trials Unit, which is core-funded by the Department of Health.
Professor Richard Gray is available for interview. To arrange interviews or for a copy of the paper contact Ben Hill, University of Birmingham Press Officer, telephone 0121 414 5134 or mobile07789 921163.