Table CDR62687 Colon Cancer Treatment/结肠癌治疗
ID Type Description_en Description_zh
w1 Word Capecitabine 卡培他滨​
w2 Word Description 描述
w3 Word Oxaliplatin 奥沙利铂​
w4 Word Bevacizumab 贝伐单抗​
w5 Word Panitumumab 帕尼单抗​
w6 Word Aflibercept 阿柏西普​
w7 Word Illustration 图示
w8 Word Irinotecan 伊立替康​
w9 Word Cetuximab 西妥昔单抗​
w10 Word Evidence (oxaliplatin): 证据（奥沙利铂）：
w11 Word colon cancer 结肠癌
w12 Word Familial polyposis 家族性息肉病
w13 Word T4 disease T4期肿瘤
w14 Word Evidence (capecitabine): 证据（卡培他滨）：
w15 Word Treatment Options 治疗方案
w16 Word Evidence (irinotecan): 证据（伊立替康）：
w17 Word Evidence (panitumumab): 证据（帕尼单抗）：
w18 Word Second-line chemotherapy 二线化疗
w19 Word Evidence (bevacizumab): 证据（贝伐单抗）：
w20 Word Palliative chemotherapy 姑息化疗
w21 Word Intra-arterial chemotherapy 动脉内化疗
w22 Word Local ablation 局部消融术
w23 Word Scirrhous tumors 硬癌
w24 Word Third-line chemotherapy 三线化疗
w25 Word Evidence (cetuximab): 证据（西妥昔单抗）：
p1 Phrase Evidence (laparoscopic techniques): 证据（腹腔镜手术）：
p2 Phrase recurrent colon cancer 复发性结肠癌
p3 Phrase Standard Treatment Options 标准治疗方案
p4 Phrase Palliative radiation therapy 姑息放疗
p5 Phrase Signet ring adenocarcinoma 腺癌印戒细胞癌
p6 Phrase stage IV colon cancer IV期结肠癌
p7 Phrase Inadequate lymph node sampling 淋巴结清扫数目不足
p8 Phrase stage 0 colon cancer 0期结肠癌
p9 Phrase A poorly differentiated histology 组织学分化较差
p10 Phrase Stage 0 colon cancer 0期结肠癌
p11 Phrase Chemotherapy regimens after 2000 2000年后使用的化疗方案
p12 Phrase Stage II Colon Cancer II期结肠癌
p13 Phrase stage II colon cancer II期结肠癌
p14 Phrase stage I colon cancer I期结肠癌
p15 Phrase Treatment options by stage 根据分期的治疗选择
p16 Phrase Stage III colon cancer III期结肠癌
p17 Phrase Stage IV colon cancer IV期结肠癌
p18 Phrase stage III colon cancer III期结肠癌
p19 Phrase Colon Cancer (PDQ®): Treatment 结肠癌（PDQ®）：治疗​
p20 Phrase Treatment of Liver Metastasis 肝转移治疗
p21 Phrase Stage I Colon Cancer I期结肠癌
p22 Phrase Adenocarcinoma (most colon cancers) 腺癌（多数结肠癌）
p23 Phrase Stage III Colon Cancer III期结肠癌
p24 Phrase Stage 0 Colon Cancer 0期结肠癌
p25 Phrase Chemotherapy and targeted therapy 化疗和靶向治疗
p26 Phrase Stage 0 Colon Cancer Treatment 0期结肠癌的治疗
p27 Phrase Stage Information for Colon Cancer 结肠癌的分期信息
p28 Phrase T1 = Tumor invades submucosa T1 = 肿瘤侵犯粘膜下层
p29 Phrase Cellular Classification of Colon Cancer 结肠癌的细胞学分类
p30 Phrase Chemotherapy regimens prior to 2000 早于2000年使用的化疗方案
p31 Phrase Stage II Colon Cancer Treatment II期结肠癌的治疗
p32 Phrase These groups include the following: 相关遗传性疾病包括：
p33 Phrase Wide surgical resection and anastomosis 广泛切除联合肠吻合术
p34 Phrase Involvement of the visceral peritoneum 肿瘤累及脏层腹膜
p35 Phrase Stage III Colon Cancer Treatment III期结肠癌的治疗
p36 Phrase Treatment Options Under Clinical Evaluation 处于临床评估阶段的治疗方案
p37 Phrase Any T, Any N, M1b 任何T，任何N，M1b
p38 Phrase Treatment options for recurrent cancer 复发性结肠癌的治疗选择
p39 Phrase Stage I Colon Cancer Treatment I期结肠癌的治疗
p40 Phrase M0 = No distant metastasis M0：无远处转移
p41 Phrase General Information About Colon Cancer 结肠癌的基本信息
p42 Phrase Any T, Any N, M1a 任何T，任何N，M1a
p43 Phrase Evidence (5-FU alone and 5-FU-semustine): 证据（单独使用5-FU或5-FU-司莫司汀）：
p44 Phrase Treatment Option Overview for Colon Cancer 结肠癌治疗选择概述
p45 Phrase T2 = Tumor invades muscularis propria T2 = 肿瘤侵犯固有肌层
p46 Phrase New cases: 102,480 (colon cancer only) 新发病例数：102,480例（仅结肠癌）
p47 Phrase AJCC Stage Groupings and TNM Definitions AJCC分期与TNM定义
p48 Phrase Added Aflibercept as a new subsection 添加“阿柏西普​”章节
p49 Phrase Surgical resection of locally recurrent cancer 手术切除局部复发性结肠癌
p50 Phrase Other prognostic factors include the following: 其他预后因素包括：
p51 Phrase MAC is the modified Astler-Coller classification MAC为改良的Astler-Coller分类标准
p52 Phrase Stage IV and Recurrent Colon Cancer Treatment IV期结肠癌与复发性结肠癌的治疗
p53 Phrase Table 4. Definitions of TNM Stage III 表4.TNM III期的定义
p54 Phrase T0 = No evidence of primary tumor T0 = 无原发肿瘤证据
p55 Phrase Table 1. Definitions of TNM Stage 0 表1.TNM 0期的定义
p56 Phrase Table 3. Definitions of TNM Stage II 表3.TNM II期的定义
p57 Phrase Levamisole alone did not confer these benefits 单独使用左旋咪唑进行化疗无此获益
p58 Phrase Deaths: 50,830 (colon and rectal cancers combined) 死亡病例数：50,830（结肠癌和直肠癌）
p59 Phrase The presence or absence of nodal involvement 是否累及淋巴结
p60 Phrase N0 = No regional lymph node metastasis N0：无区域淋巴结转移
p61 Phrase Table 5. Definitions of TNM Stage IV 表5.TNM IV期的定义
p62 Phrase TX = Primary tumor cannot be assessed TX = 原发肿瘤无法评估
p63 Phrase Table 2. Definitions of TNM Stage I 表2.TNM I期的定义
p64 Phrase Added Third-line chemotherapy as a new subsection 添加“三线化疗”章节
p65 Phrase The presence or absence of distant metastases 是否有远处转移
s1 Sentence Clinical trials evaluating new drugs and biological therapy 评估新药和生物治疗的临床试验
s2 Sentence Local excision or simple polypectomy with clear margins 局部切除，或保证无瘤切缘的单纯息肉切除术
s3 Sentence N2a = Metastases in 4–6 regional lymph nodes N2a：4-6枚区域淋巴结转移
s4 Sentence Treatment of Stage IV and Recurrent Colon Cancer IV期结肠癌和复发性结肠癌的治疗
s5 Sentence Stage III colon cancer denotes lymph node involvement III期结肠癌表示已有淋巴结受累
s6 Sentence N1 = Metastases in 1–3 regional lymph nodes N1：1-3枚区域淋巴结转移
s7 Sentence Standard Treatment Options for Stage III Colon Cancer III期结肠癌的标准治疗选择
s8 Sentence Standard Treatment Options for Stage II Colon Cancer II期结肠癌的标准治疗选择
s9 Sentence Gastrointestinal stromal tumors can occur in the colon 胃肠道间质瘤亦可发生于结肠
s10 Sentence N2 = Metastases in ≥4 regional lymph nodes N2 = ≥4枚区域淋巴结转移
s11 Sentence These trials employed 5-FU alone or 5-FU-semustine (methyl-CCNU) 这些临床研究仅使用5-FU或5-FU-司莫司汀（甲基环己亚硝脲，即甲基-CCNU）作为化疗药物
s12 Sentence A personal history of colorectal cancer or adenomas 结直肠癌或腺瘤病史
s13 Sentence The lead reviewers for Colon Cancer Treatment are: 结肠癌治疗的首席审核人为：
s14 Sentence Standard Treatment Options for Stage 0 Colon Cancer 0期结肠癌的标准治疗选择
s15 Sentence Histologic types of colon cancer include the following: 结肠癌的组织学分型包括：
s16 Sentence Stage IV colon cancer denotes distant metastatic disease IV期结肠癌表明已存在远处转移
s17 Sentence N1a = Metastasis in 1 regional lymph node N1a = 1枚区域淋巴结转移
s18 Sentence N1b = Metastases in 2–3 regional lymph nodes N1b：2-3枚区域淋巴结转移
s19 Sentence Standard Treatment Options for Stage I Colon Cancer I期结肠癌的标准治疗选择
s20 Sentence First-degree family history of colorectal cancer or adenomas 一级亲属中有结直肠癌或腺瘤病史
s21 Sentence N2b = Metastases in ≥7 regional lymph nodes N2b = ≥7枚区域淋巴结转移
s22 Sentence NX = Regional lymph nodes cannot be assessed NX：区域淋巴结无法评估
s23 Sentence Tis = Carcinoma: intraepithelial or invasion of lamina propria Tis = 原位癌：局限于上皮内或侵犯粘膜固有层
s24 Sentence Expert-reviewed information summary about the treatment of colon cancer 关于结肠癌治疗的专家审核信息
s25 Sentence M1b = Metastases in >1 organ/site or the peritoneum M1b：远处转移分布于一个以上的器官/部位或腹膜转移
s26 Sentence A personal history of ovarian, endometrial, or breast cancer 卵巢癌、子宫内膜癌或乳腺癌病史
s27 Sentence A personal history of ulcerative colitis or Crohn colitis 溃疡性结肠炎或克罗恩结肠炎病史
s28 Sentence Drug combinations described in this section include the following: 本章节将介绍下列化疗联合用药方案：
s29 Sentence Table 6. Standard Treatment Options for Stages 0–III Colon Cancer 表6. 0-III期结肠癌标准治疗方案
s30 Sentence Unusual Cancers of Childhood Treatment (childhood cancer of the colon) 罕见儿童肿瘤的治疗（儿童结肠癌）
s31 Sentence Colon resection for larger lesions not amenable to local excision 对不宜局部切除的较大病灶行结肠切除术
s32 Sentence Resection of isolated pulmonary or ovarian metastases in selected patients 对于某些单发结肠癌肺转移或者卵巢转移患者，行手术切除
s33 Sentence Bowel obstruction and bowel perforation are indicators of poor prognosis 肠梗阻和肠穿孔提示预后不良
s34 Sentence More common conditions with an increased risk include the following: 其他增加结直肠癌患病风险的常见情况包括：
s35 Sentence T3 = Tumor invades through the muscularis propria into pericolorectal tissues T3 = 肿瘤穿透固有肌层到达结直肠旁组织
s36 Sentence T4a = Tumor penetrates to the surface of the visceral peritoneum T4a：肿瘤穿透脏层腹膜表面
s37 Sentence Standard treatment options for stage III colon cancer include the following: III期结肠癌的标准治疗选择包括：
s38 Sentence cTNM is the clinical classification, and pTNM is the pathologic classification cTNM为临床分类，pTNM为病理分类
s39 Sentence Standard treatment options for stage I colon cancer include the following: I期结肠癌的标准治疗选择包括：
s40 Sentence Standard treatment options for stage II colon cancer include the following: II期结肠癌​的标准治疗选择包括：
s41 Sentence The same classification is used for both clinical and pathologic staging 此分类同样适用于临床和病理分期
s42 Sentence Standard treatment options for stage 0 colon cancer include the following: 0期结肠癌的标准治疗选择包括：
s43 Sentence Table 7. Treatment Options for Stage IV and Recurrent Colon Cancer 表7. IV期与复发性结肠癌的治疗方案
s44 Sentence The degree of penetration of the tumor through the bowel wall 肿瘤对肠壁的浸润程度
s45 Sentence Hereditary nonpolyposis colon cancer (HNPCC) or Lynch syndrome variants I and II 遗传性非息肉病性结肠癌（HNPCC）或Lynch综合征I型与II型
s46 Sentence The explanations for superscripts a–g are at the end of Table 5 上标a-g的说明见表5​后注释
s47 Sentence A review of the use of this tumor marker suggests the following: 相关综述显示：
s48 Sentence Hepatic metastasis may be considered to be resectable based on the following: 以下情况肝转移可考虑手术切除：
s49 Sentence (Refer to the PDQ summary on Colorectal Cancer Screening for more information.) （更多信息请参见PDQ总结：结直肠癌的筛查）
s50 Sentence Surgery for stage III colon cancer is wide surgical resection and anastomosis III期结肠癌的手术治疗为广泛外科切除联合肠吻合术
s51 Sentence Tis = Carcinoma in situ : intraepithelial or invasion of lamina propria Tis = 原位癌：局限于上皮内或侵犯粘膜固有层
s52 Sentence Treatment options for stage IV and recurrent colon cancer include the following: IV期结肠癌和复发性结肠癌的治疗选择包括：
s53 Sentence The AJCC has designated staging by TNM classification to define colon cancer 根据TNM分类，AJCC制定了结肠癌分期系统
s54 Sentence Other PDQ summaries containing information related to colon cancer include the following: 其他与结肠癌相关的PDQ总结请参见：
s55 Sentence Clinical trials comparing various chemotherapy regimens or biological therapy, alone or in combination 对比不同化疗方案或生物治疗方案（单独或联合使用）的临床试验
s56 Sentence T = primary tumor; N = regional lymph nodes; M = distant metastasis T=原发肿瘤；N=区域淋巴结；M=远处转移
s57 Sentence (Refer to the PDQ summary on Gastrointestinal Stromal Tumors Treatment for more information.) （更多信息请参见PDQ总结胃肠道间质瘤的治疗​）
s58 Sentence The prognosis of patients with colon cancer is clearly related to the following: 结肠癌患者的预后与以下因素明确相关：
s59 Sentence T4b = Tumor directly invades or is adherent to other organs or structures T4b = 肿瘤直接侵犯或粘连于其他器官或组织结构
s60 Sentence Elevated pretreatment serum levels of carcinoembryonic antigen (CEA) have a negative prognostic significance 治疗前血清癌胚抗原（CEA）水平高提示预后不良
s61 Sentence Tumor that is adherent to other organs or structures, grossly, is classified cT4b 大体观察见粘连于其他器官或结构上的肿瘤，可以分为cT4b期
s62 Sentence Because of its localized nature, stage I colon cancer has a high cure rate I期结肠癌​病灶局限，治愈率高
s63 Sentence Such approaches have not led to improvements in long-term outcome measures such as survival 然而这些方法并未改善包括生存在内的长期治疗效果
s64 Sentence Since 2000, capecitabine has been established as an equivalent alternative to 5-FU and leucovorin 2000年之后，卡培他滨逐渐成为5-FU和亚叶酸的等效替代药物
s65 Sentence Bevacizumab is a partially humanized monoclonal antibody that binds to vascular endothelial growth factor 贝伐单抗是一种结合血管内皮生长因子的部分人源化单克隆抗体
s66 Sentence Three-year recurrence rates and 3-year overall survival rates were similar in the two groups 两组3年复发率和3年总生存率均相似
s67 Sentence Following surgery, patients should be considered for entry into a carefully controlled clinical trial 结肠癌患者术后应考虑参加设计良好的临床试验
s68 Sentence These three characteristics form the basis for all staging systems developed for this disease 这三项特征构成了所有结肠癌分期系统的基础
s69 Sentence Neuroendocrine Tumors with neuroendocrine differentiation typically have a poorer prognosis than pure adenocarcinoma variants 神经内分泌肿瘤：有神经内分泌分化特征的肿瘤，预后差于单纯腺癌
s70 Sentence Oxaliplatin has significant activity when combined with 5-FU-leucovorin in patients with metastatic colorectal cancer 奥沙利铂联用5-FU-亚叶酸方案对转移性结直肠癌患者有显著疗效
s71 Sentence The AIO Colorectal Study Group randomly assigned 474 patients to either FUFOX or CAPOX AIO结直肠研究组将474例患者随机分为FUFOX组和CAPOX组
s72 Sentence New surveillance methods, including CEA immunoscintigraphy and positron emission tomography, are under clinical evaluation CEA免疫闪烁显像和正电子发射断层扫描（PET）等新型监测手段尚处于临床评估阶段
s73 Sentence Routine use of CEA levels alone for monitoring response to treatment should not be recommended 不推荐常规使用CEA监测治疗反应
s74 Sentence M1a = Metastasis confined to 1 organ or site (e.g., liver, lung, ovary, nonregional node) M1a = 远处转移局限于单个器官或部位（如肝脏、肺、卵巢、非区域性淋巴结）
s75 Sentence CEA is a serum glycoprotein frequently used in the management of patients with colon cancer CEA是结肠癌患者治疗中频繁使用到的一种血清糖蛋白
s76 Sentence In addition to standard radiographic procedures, radioimmunoscintography may add clinical information that may affect management 除了标准的影像学检查，放射免疫成像也可以为治疗提供更多的临床信息
s77 Sentence (Refer to the Stage III Colon Cancer Treatment section of this summary for more information.) （更多信息请见本节：III期结肠癌的治疗）
s78 Sentence Regorafenib is an inhibitor of multiple tyroisine kinase pathways including vascular endothelial growth factor (VEGF) 瑞戈非尼是血管内皮生长因子（VEGF）等多种酪氨酸激酶通路的抑制剂
s79 Sentence The NCCTG conducted a randomized trial comparing surgical resection alone with postoperative levamisole or 5-FU-levamisole NCCTG进行的一项随机临床试验对比了单纯切除手术和手术联合术后左旋咪唑或5-FU-左旋咪唑辅助化疗的疗效
s80 Sentence (Refer to the Stage II Colon Cancer Treatment section of this summary for more information.) （更多信息请见本节：II期结肠癌的治疗）
s81 Sentence Note: Estimated new cases and deaths from colon cancer in the United States in 2013: 注：据估计，2013年美国结肠癌新发病例数和死亡病例数约为：
s82 Sentence The potential value of adjuvant chemotherapy for patients with stage II colon cancer is controversial 对于II期结肠癌患者，辅助化疗的潜在价值尚存争议
s83 Sentence Treatment options under clinical evaluation for stage IV and recurrent colon cancer include the following: 对于IV期结肠癌和复发性结肠癌，目前处于临床评估阶段的治疗方案包括：
s84 Sentence The potential value of adjuvant chemotherapy for patients with stage II colon cancer remains controversial 辅助化疗对II期结肠癌患者的治疗价值尚存争议
s85 Sentence Recurrence following surgery is a major problem and is often the ultimate cause of death 而术后复发是一个重要问题，常最终导致患者死亡
s86 Sentence Patients were randomly assigned to receive regorafenib or placebo in addition to best supportive care 这些患者被随机分组，接受瑞戈非尼或安慰剂治疗，且同时接受最佳支持治疗
s87 Sentence Three-year recurrence rates and 3-year overall survival (OS) rates were similar in the two groups 两组3年复发率和3年总生存率均相似
s88 Sentence (Refer to the PDQ summaries on Colorectal Cancer Screening and Colorectal Cancer Prevention for more information.) （更多信息请参见PDQ总结：结直肠癌的筛查与结直肠癌的预防）
s89 Sentence The GRECCR-03 and NCRI-QUASAR1 trials evaluated the use of systemic or regional chemotherapy or biologic therapy GRECCR-03与NCRI-QUASAR1临床试验评估了全身化疗、局部化疗和生物治疗的效果
s90 Sentence For patients with metastatic colon cancer, two studies have demonstrated the equivalence of capecitabine to 5-FU-leucovorin 对于转移性结肠癌患者，两项临床研究显示了卡培他滨和5-FU-亚叶酸的等效性
s91 Sentence Treatment of patients with recurrent or advanced colon cancer depends on the location of the disease 复发性或晚期结肠癌患者的治疗取决于肿瘤病灶位置
s92 Sentence To date, no large-scale randomized trials have documented the efficacy of a standard, postoperative monitoring program 至今尚无大型随机临床试验证明术后标准化随访计划的有效性
s93 Sentence Improved surgical techniques and advances in preoperative imaging have allowed for better patient selection for resection 外科技术的发展和术前影像学的进步帮助医生可以更准确地选择手术病人
s94 Sentence Adjuvant therapy is not indicated for most patients unless they are entered into a clinical trial 除参加临床试验外，多数患者无需辅助化疗
s95 Sentence For patients with stage III colon cancer, capecitabine provides equivalent outcome to intravenous 5-FU and leucovorin III期结肠癌患者接受卡培他滨辅助化疗的效果等同于静脉推注5-FU和亚叶酸
s96 Sentence Surgical resection and anastomosis or bypass of obstructing or bleeding primary lesions in selected metastatic cases 对原发灶引起梗阻或出血的转移病例，手术切除原发灶、消化道重建，或捷径手术
s97 Sentence Patients who received bevacizumab experienced an improved OS compared with the patients who did not receive bevacizumab 结果显示，相比于单纯化疗组，含贝伐单抗的化疗组OS显著改善
s98 Sentence The role of laparoscopic techniques in the treatment of colon cancer has been examined in two studies 两项研究评估了腹腔镜在结肠癌治疗中的价值
s99 Sentence Updated statistics with estimated new cases and deaths for 2013 (cited American Cancer Society as reference 1) 更新了2013年新发病例和死亡病例统计数据​（引用美国癌症协会参考文献1）
s100 Sentence Eligible patients should be considered for entry into carefully controlled clinical trials comparing various postoperative chemotherapy regimens 相比各种术后辅助化疗方案，应鼓励符合条件的患者参加设计良好的临床研究
s101 Sentence Cancer of the colon is a highly treatable and often curable disease when localized to the bowel 结肠癌治疗效果好，肠道局限性病变通常可以治愈
s102 Sentence Surgery is the primary form of treatment and results in cure in approximately 50% of the patients 外科手术是主要的治疗手段，约50%的术后病人能够痊愈
s103 Sentence Patients with previously untreated metastatic colorectal cancer were randomly assigned to either IFL or IFL and bevacizumab 初治转移性结直肠癌患者随机分组，分别接受IFL方案或IFL联合贝伐单抗方案治疗
s104 Sentence N1c = Tumor deposit(s) in the subserosa, mesentery, or nonperitonealized pericolic or perirectal tissues without regional nodal metastasis N1c = 浆膜下、肠系膜、无腹膜覆盖结肠/直肠周围组织内有肿瘤种植，无区域淋巴结转移
s105 Sentence At the 2012 American Society of Clinical Oncology Annual Meeting, data was presented from a randomized, controlled trial 2012年美国临床肿瘤学协会年会发表了一些来自随机对照临床试验的数据
s106 Sentence The quality-of-life component of this trial has been published and minimal short-term quality-of-life benefits with LAC were reported 该项研究的生活质量部分另行发表，结果显示LAC术后有很小的短期生活质量获益
s107 Sentence Three randomized studies demonstrated improved response rates, PFS, and OS when irinotecan or oxaliplatin was combined with 5-FU-leucovorin 三项随机临床试验显示，当伊立替康或奥沙利铂与5-FU-亚叶酸联合化疗时，患者缓解率、PFS和OS均有改善
s108 Sentence Following treatment of colon cancer, periodic evaluations may lead to the earlier identification and management of recurrent disease 结肠癌治疗后，定期随访可以帮助早发现、早治疗复发病变
s109 Sentence In a phase III trial, patients with chemotherapy-refractory colorectal cancer were randomly assigned to panitumumab or best supportive care 一项III期临床试验将化疗无效的难治性结直肠癌患者随机分入帕尼单抗组或最佳支持治疗组
s110 Sentence Postoperative CEA testing should be restricted to patients who would be candidates for resection of liver or lung metastases 术后CEA检测应仅限于准备行肝转移或肺转移切除手术的患者
s111 Sentence Bevacizumab can reasonably be added to either FOLFIRI or FOLFOX for patients undergoing first-line treatment of metastatic colorectal cancer 贝伐单抗可以合理的加入FOLFIRI或FOLFOX化疗方案，作为一线方案治疗转移性结直肠癌患者
s112 Sentence A multicenter, prospective, randomized, noninferiority trial ( NCCTG-934653 ) compared laparoscopic-assisted colectomy (LAC) with open colectomy in 872 patients 一项多中心前瞻性非劣效性随机临床试验（NCCTG-934653）在872例患者中比较了腹腔镜辅助结肠切除术（LAC）和开腹结肠切除术的效果
s113 Sentence The U.S. Food and Drug Administration approved panitumumab for use in patients with metastatic colorectal cancer refractory to chemotherapy 美国食品药品监督管理局（FDA）已批准帕尼单抗用于治疗化疗耐药的转移性结直肠癌患者
s114 Sentence Treatment of recurrent colon cancer depends on the sites of recurrent disease demonstrable by physical examination and/or radiographic studies 复发性结肠癌的治疗效果取决于体格检查和（或）影像学检查所发现的复发部位
s115 Sentence Several studies show increased local toxic effects with hepatic infusional therapy, including liver function abnormalities and fatal biliary sclerosis 一些研究指出，肝脏灌注治疗的局部毒性增加更高，如肝功能异常和致命性的胆管硬化
s116 Sentence An intergroup study ( NCCTG-N9741 ) compared IFL with FOLFOX4 in first-line treatment for patients with metastatic colorectal cancer 一项组间研究（NCCTG-N9741）对比了IFL和FOLFOX4作为一线治疗方案用于转移性结直肠癌患者的有效性
s117 Sentence Subsequent studies tested the combination of 5-FU-leucovorin in the adjuvant treatment of patients with resected carcinoma of the colon 后续研究评估了结肠癌术后使用含5-FU-亚叶酸的治疗效果
s118 Sentence (Refer to the Primary Surgical Therapy section in the Treatment Option Overview section of this summary for more information.) （更多信息请参见：治疗方案概述章节中的主要外科治疗）
s119 Sentence Patients who have a complete pathologic response (ypT0, N0, cM0) may be similar to stage group 0 or I 病理完全缓解（ypT0, N0, cM0）的患者预后与0期或I期患者相似
s120 Sentence Surgery is curative in 25% to 40% of highly selected patients who develop resectable metastases in the liver and lung 对于精心选择的可切除结肠癌肝转移和肺转移患者，手术治愈率可达25%至40%
s121 Sentence The addition of oxaliplatin to 5-FU and leucovorin has been shown to improve OS compared with 5-FU and leucovorin alone 同时，相比5-FU联合亚叶酸方案，5-FU、亚叶酸联合奥沙利铂方案改善了患者的OS
s122 Sentence Features in patients with stage II colon cancer that are associated with an increased risk of recurrence include the following: 复发风险较高的II期结肠癌患者的特点如下：
s123 Sentence In September 2012, the FDA granted approval for the use of regorafenib in patients who had progressed on prior therapy 2012年9月，FDA批准瑞戈非尼应用于治疗后疾病进展的癌症患者
s124 Sentence The median TTP for FOLFOX4 versus LV5FU2 was 4.6 months versus 2.7 months (stratified log-rank test, 2-sided P < .001) FOLFOX4和LV5FU2治疗组患者的中位TTP分别为4.6个月和2.7个月（分层秩和检验，双边P<0.001）
s125 Sentence FOLFOX has become the reference standard for the next generation of clinical trials for patients with stage III colon cancer FOLFOX方案现已成为新一代III期结肠癌临床试验的标准参考方案
s126 Sentence Subsequently, two studies compared FOLFOX with FOLFIRI, and patients were allowed to cross over upon progression on first-line therapy, respectively 两项后续研究对比了FOLFOX和FOLFIRI化疗方案，并允许一线治疗后进展的患者交叉至对组
s127 Sentence Added text to include aflibercept as one of the eight active and approved drugs for patients with metastatic colorectal cancer 添加内容​：阿柏西普经批准成为八种有效且获准治疗转移性结直肠癌的药物之一
s128 Sentence The Crystal Study ( NCT00154102 ) randomly assigned 1,198 patients with stage IV colorectal cancer to FOLFIRI with or without cetuximab Crystal研究（NCT00154102）招募了1,198例IV期结直肠癌患者，随机分组为FOLFIRI联合西妥昔单抗方案治疗，或者仅接受FOLFIRI方案治疗
s129 Sentence In one trial, 1,226 patients were randomly assigned to receive aflibercept (4mg/kgIV) or placebo every 2 weeks in combination with FOLFIRI 其中一项临床试验招募了1,226例患者，所有患者被随机分组，接受每两周一次阿柏西普（4mg/kgIV）或安慰剂治疗，并联合使用FOLFIRI方案
s130 Sentence Retrospective studies demonstrated that the number of lymph nodes examined in colon and rectal surgery may be associated with patient outcome 回顾性研究显示，结直肠手术清扫的淋巴结数量可能与患者预后相关
s131 Sentence Added text to state that for patients with stage III colon cancer, capecitabine provides equivalent outcome to intravenous 5-FU and leucovorin 添加内容：对于III期结肠癌患者，卡培他滨有效性等同于静脉用5-FU和亚叶酸
s132 Sentence For patients with locally recurrent and/or liver-only and/or lung-only metastatic disease, surgical resection, if feasible, is the only potentially curative treatment 对于局部复发、和（或）仅有肝转移、和（或）仅有肺转移的患者，如果可能，则手术切除是其唯一的治愈手段
s133 Sentence Prior to 2000, 5-FU was the only useful cytotoxic chemotherapy in the adjuvant setting for patients with stage III colon cancer 2000年以前，对于III期结肠癌患者，5-FU是唯一有效的细胞毒性辅助化疗药物
s134 Sentence Aflibercept is a novel anti-VEGF molecule and has been evaluated as a component of second-line therapy in patients with metastatic colorectal cancer 阿柏西普是一种新型抗VEGF分子，已有研究评估该药作为二线治疗对转移性结直肠癌患者的有效性
s135 Sentence Many of the early randomized studies of 5-FU in the adjuvant setting failed to show a significant improvement in survival for patients 许多早期随机临床试验显示含5-FU的辅助化疗并不改善患者生存
s136 Sentence In addition to INT-0089, multiple studies have refined the use of 5-FU-leucovorin in the adjuvant setting and can be summarized as follows: 除INT-0089外，多项其他临床研究调整了5-FU-亚叶酸在辅助化疗中的使用方法，具体总结如下：
s137 Sentence Radiofrequency ablation has emerged as a safe technique (2% major morbidity and <1% mortality rate) that may provide for long-term tumor control 射频消融术是一种安全的治疗手段（严重并发症率2%，死亡率小于1%），可能实现长期控制肿瘤的效果
s138 Sentence A CEA level is not a valuable screening test for colorectal cancer because of the large numbers of false-positive and false-negative reports CEA筛查结直肠癌的价值有限，假阳性和假阴性报道均很多
s139 Sentence Standard treatment for patients with colon cancer has been open surgical resection of the primary and regional lymph nodes for localized disease 局限性结肠癌的标准治疗一直以来都是开腹手术切除原发病灶与区域淋巴结
s140 Sentence Capecitabine is an oral fluoropyrimidine that undergoes a three-step enzymatic conversion to 5-FU with the last step occurring in the tumor cell 卡培他滨是一种口服氟嘧啶药物，在体内经过3步酶转化反应产生5-FU，最后一步发生在肿瘤细胞中
s141 Sentence The safety and effectiveness of regorafenib were evaluated in a single, clinical study of 760 patients with previously treated metastatic colorectal cancer 一项单中心临床研究评估了瑞戈非尼的安全性和有效性，该研究招募了760例曾接受过治疗的转移性结直肠癌患者
s142 Sentence For patients who have progressed on irinotecan-containing regimens, a randomized, phase II study was performed of either cetuximab or irinotecan and cetuximab 针对接受含伊立替康化疗方案治疗后仍进展的患者，一项II期随机临床研究比较了西妥昔单抗或者伊立替康联合西妥昔单抗的疗效
s143 Sentence After bevacizumab was approved, the BICC-C trial was amended, and an additional 117 patients were randomly assigned to receive FOLFIRI/bevacizumab or mIFL/bevacizumab 贝伐单抗获准使用后，BICC-C临床研究对研究方案进行了修正，新招募117例患者随机分为FOLFIRI/贝伐单抗治疗组或mIFL/贝伐单抗治疗组
s144 Sentence One small, single-institution randomized study of 219 patients showed that the LAC procedure was independently associated with reduced tumor recurrence on multivariate analysis 在另一项219例患者参加的单中心随机临床研究中，多因素分析发现LAC手术是降低肿瘤复发率的独立预后因素
s145 Sentence Based on these studies, bevacizumab can reasonably be added to either FOLFIRI or FOLFOX for patients undergoing first-line treatment of metastatic colorectal cancer 基于以上研究结果，有理由将贝伐单抗加入FOLFIRI或FOLFOX化疗方案，作为治疗转移性结直肠癌的一线方案
s146 Sentence The addition of cetuximab to multiagent chemotherapy improves survival in patients with colon cancers that lack a KRAS mutation (i.e., KRAS wild type) 在多药联合化疗方案中添加西妥昔单抗可改善无KRAS突变（即KRAS基因野生型）的结肠癌患者的生存率
s147 Sentence However, if no tumor is present in the adhesion, microscopically, the classification should be pT1–4a depending on the anatomical depth of wall invasion 若镜下未发现粘连处存在肿瘤，则根据肿瘤浸润肠壁深度更改分期为pT1-4a
s148 Sentence In the PRIME (NCT00364013) study, 1,183 patients were randomly assigned to FOLFOX4 with or without panitumumab as first-line therapy for metastatic colorectal cancer 在PRIME研究（NCT00364013）中，1,183例转移性结直肠癌患者被随机分组，接受含帕尼单抗和不含帕尼单抗的FOLFOX4方案作为一线治疗
s149 Sentence Treatment decisions should be made with reference to the TNM classification rather than to the older Dukes or the Modified Astler-Coller classification schema 参照TNM分期制定治疗方案，而不是老版Dukes分类法或改良的Astler-Coller分类法
s150 Sentence Similarly, a phase III trial randomly assigned patients who progressed on irinotecan and 5-FU-leucovorin to bolus and infusional 5-FU-leucovorin (LV5FU2), single-agent oxaliplatin, or FOLFOX4 类似地，一项III期临床试验以曾接受伊立替康联合5-FU-亚叶酸治疗的患者为研究对象，将他们随机分为5-FU静脉推注与输液联合亚叶酸（LV5FU2方案）、奥沙利铂单药治疗或FOLFOX4方案的患者
s151 Sentence Aflibercept also significantly improved PFS (HR, 0.758; 95% CI, 0.661–0.869; P < .0001), with median PFS times of 6.90 months versus 4.67 months, respectively 阿柏西普亦显著延长患者的PFS（HR，0.758；95%CI，0.661-0.869；P<0.0001），阿柏西普和安慰剂组的中位PFS分别为6.90月和4.67月
s152 Sentence Of those randomly assigned patients, 27% were deemed ineligible at the time of surgery, which left only 75 patients evaluable for recurrence and survival 这些随机分组的患者中，27%的患者在术前被评估为不适合进行手术，故仅余75名患者可进行复发率和生存率评估
s153 Sentence Second-line chemotherapy with irinotecan in patients treated with 5-FU-leucovorin as first-line therapy demonstrated improved OS when compared with either infusional 5-FU or supportive care 对于以5-FU-亚叶酸作为一线治疗的患者，伊立替康二线化疗与5-FU输液或支持治疗相比，可使患者OS有所改善
s154 Sentence Currently, there are eight active and approved drugs for patients with metastatic colorectal cancer that are used alone and in combination with other drugs: 目前，已有八种有效药物获得批准用于转移性结直肠癌的单独或联合用药：
s155 Sentence A major question was whether the use of bevacizumab after first-line therapy was warranted when bevacizumab was used as a component of first-line therapy 贝伐单抗面临的一个主要问题在于，当贝伐单抗作为一线疗法的一部分时，一线治疗后是否继续使用贝伐单抗尚有争议
s156 Sentence Treatment decisions depend on factors such as physician and patient preferences and the stage of the disease, rather than the age of the patient 治疗意见取决于医生、患者，以及疾病分期等因素，但与病人年龄无关
s157 Sentence On the basis of these results, the use of FOLFIRI plus aflibercept is an acceptable second-line regimen for patients previously treated with FOLFOX-based chemotherapy 在上述结果基础上，对于既往接受FOLFOX方案治疗的患者，可以将FOLFIRI联合阿柏西普方案作为二线治疗方案
s158 Sentence Investigators from the Eastern Cooperative Oncology Group randomly assigned patients who had progressed on 5-FU-leucovorin and irinotecan to either FOLFOX or FOLFOX and bevacizumab 在东部肿瘤协作组开展的研究中，接受5-FU-亚叶酸和伊立替康化疗后出现疾病进展的患者随机分组接受FOLFOX或FOLFOX联合贝伐单抗治疗
s159 Sentence Pooled analyses and meta-analyses have suggested a 2% to 4% improvement in OS for patients treated with adjuvant fluorouracil (5-FU)–based therapy compared with observation 汇总分析和荟萃分析显示，在采取以氟尿嘧啶（5-FU）为基础的化疗组与观察组的比较中，化疗组患者OS提高2%-4%
s160 Sentence The XELOX regimen: Oral capecitabine (1,000 mg/m^2 ) twice a day for 14 days plus oxaliplatin (130 mg/m^2 ) on day 1 every 3 weeks XELOX化疗方案：每日口服卡培他滨（1,000mg/m2）2次，连续14天，同时第1天奥沙利铂输液（130mg/m2），每三周重复一次
s161 Sentence Patients treated with regorafenib had a statistically significant improvement in OS (6.4 months vs 5 months, HR, 0.493; 95% CI, 0.418–0.581; 1-sided P < .000001) 瑞戈非尼治疗组患者OS得到了统计学显著改善（分别为6.4个月和5个月，HR，0.493，95%CI，0.418-0.581，单边P<0.000001）
s162 Sentence Groups that have a high incidence of colorectal cancer include those with hereditary conditions. Together, these groups account for 10% to 15% of colorectal cancers 结直肠癌高发人群包括有遗传病家族史的群体，占所有结直肠癌患者的10%-15%
s163 Sentence Radiofrequency ablation and cryosurgical ablation remain options for patients with tumors that cannot be resected and for patients who are not candidates for liver resection 肿瘤不可切除或禁忌肝切除的患者可以选择射频消融或冷冻消融术
s164 Sentence The decision to use adjuvant chemotherapy for patients with stage II colon cancer is complicated and requires thoughtful consideration by both patients and their physicians II期结肠癌患者是否使用辅助化疗较为复杂，需要患者及其主治医师的谨慎考量
s165 Sentence Hepatic intra-arterial chemotherapy with floxuridine for liver metastases has produced higher overall response rates but no consistent improvement in survival when compared with systemic chemotherapy 肝动脉内氟脲苷化疗可提高肝转移患者的总体缓解率，但与全身化疗相比，动脉内化疗并未获得相似的生存改善
s166 Sentence Since the publication of these studies, the use of either FOLFOX or FOLFIRI is considered acceptable for first-line treatment of patients with metastatic colorectal cancer 研究发表后，FOLFOX或FOLFIRI作为一线方案治疗转移性结直肠癌患者的作用得到认可
s167 Sentence Resection of liver metastases in selected metastatic patients (5-year cure rate for resection of solitary or combination metastases exceeds 20%) or ablation in selected patients 对某些结肠癌肝转移患者（单发或多发转移瘤切除术后5年治愈率超过20%），行手术切除或消融术
s168 Sentence Whether to continue bevacizumab or initiate aflibercept in second-line therapy has not been addressed as yet in any clinical trial, and there are no data available 对于是否二线治疗中继续使用贝伐单抗，或二线治疗开始即使用阿柏西普的问题，由于目前尚无相关临床试验，因此无相关数据
s169 Sentence Based on results from the MOSAIC trial, adjuvant FOLFOX4 demonstrated prolonged OS for patients with stage III colon cancer compared with patients receiving 5-FU-leucovorin without oxaliplatin MOSAIC临床试验结果显示，与不含奥沙利铂的5-FU-亚叶酸方案相比，FOLFOX4方案延长了III期结肠癌患者的OS
s170 Sentence Approximately 50% of colon cancer patients will be diagnosed with hepatic metastases, either at the time of initial presentation or as a result of disease recurrence 约有50%的结肠癌患者在诊断时已有肝转移病灶，肝转移可以为首发表现，或疾病复发表现
s171 Sentence Tis includes cancer cells confined within the glandular basement membrane (intraepithelial) or mucosal lamina propria (intramucosal) with no extension through the muscularis mucosae into the submucosa Tis包括肿瘤细胞局限于腺体基底膜（上皮内）或粘膜固有层（粘膜内），未穿透粘膜肌层抵达粘膜下层
s172 Sentence Patients with limited pulmonary metastases, and patients with both pulmonary and hepatic metastases, may also be considered for surgical resection, with 5-year survival possible in highly-selected patients 某些局限性肺转移、或同时肝肺转移者也可考虑手术切除，甚至实现长期生存
s173 Sentence In a large confirmatory intergroup trial, 5-FU-levamisole prolonged DFS and OS in patients with stage III colon cancer compared with patients who received no treatment after surgery 一项大型验证性组间临床试验显示，和术后不接受任何治疗的患者相比，5-FU-左旋咪唑辅助化疗延长了III期结肠癌患者的DFS和OS时间
s174 Sentence Despite the lack of direct data, in standard practice, bevacizumab was added to FOLFOX as a standard first-line regimen based on the results of the NCCTG-N9741 trial 尽管缺乏直接数据，基于NCCTG-N9741临床研究结果，目前在实践中已将贝伐单抗加入FOLFOX方案作为标准一线治疗方案
s175 Sentence A meta-analysis of the randomized studies, which were all done in the era when only fluoropyrimidines were available for systemic therapy, did not demonstrate a survival advantage 一项荟萃分析汇总了仅有氟嘧啶作为全身化疗药物时代的多项临床研究，此分析发现患者生存时间并无获益
s176 Sentence Prior to the advent of multiagent chemotherapy, two randomized studies demonstrated that capecitabine was associated with equivalent efficacy when compared with the Mayo Clinic regimen of 5-FU-leucovorin 在多药联合化疗之前，两项随机临床研究显示卡培他滨的化疗有效性与梅奥诊所方案（5-FU-亚叶酸方案）基本相同
s177 Sentence In the trial, 820 patients with metastatic colorectal cancer, after progressing on first-line chemotherapy that included bevacizumab, were randomly assigned to chemotherapy without bevacizumab or chemotherapy with bevacizumab 这项临床试验招募了820例转移性结直肠癌患者，入组者为已接受含有贝伐单抗的一线化疗后出现疾病进展的病例，研究者将这些患者随机分入单纯化疗组和含贝伐单抗的化疗组
s178 Sentence The Bolus, Infusional, or Capecitabine with Camptosar-Celecoxib (BICC-C) trial evaluated several different irinotecan-based regimens in patients with previously untreated metastatic colorectal cancer, including FOLFIRI, mIFL, and Capecitabine/irinotecan (CAPIRI) 静脉推注、输液或卡培他滨联合盐酸伊立替康-塞来昔布（BICC-C​）临床试验评估了几项不同的基于伊立替康的化疗方案，用于治疗初治的转移性结直肠癌患者，评估的方案包括FOLFIRI、mIFL和卡培他滨/伊立替康方案（CAPIRI）
s179 Sentence In another study ( NCT00339183 ), patients with metastatic colorectal cancer who had already received a fluoropyrimidine regimen were randomly assigned to either FOLFIRI or FOLFIRI plus panitumumab 另一项研究（NCT00339183​）将氟嘧啶化疗后的转移性结直肠癌患者随机分组，接受FOLFIRI或FOLFIRI-帕尼单抗化疗
s180 Sentence The CAPOX regimen: Capecitabine (1,000 mg/m2 ) twice a day on days 1 through 14 plus oxaliplatin (70 mg/m2 ) on days 1 and 8 every 3 weeks CAPOX化疗方案：第1-14天卡培他滨（1,000mg/m2）输液，每天2次，并且第1-8天奥沙利铂（70mg/m2）输液，每三周重复一次
s181 Sentence The optimal regimen and frequency of follow-up examinations are not well defined because the impact on patient survival is not clear and the quality of data is poor 由于随访意义不明确，数据质量不佳，因此最佳的随访方案和随访频率并未确定
s182 Sentence These high-risk groups account for only 23% of all colorectal cancers. Limiting screening or early cancer detection to only these high-risk groups would miss the majority of colorectal cancers 这些高危人群仅占全体结直肠癌患者的23%，因此，仅限于此类高危人群的早期癌症筛查将会遗漏大部分结直肠癌患者
s183 Sentence The completed Intergroup trial 0089 ( INT-0089 ) randomly assigned 3,794 patients with high-risk stage II or stage III colon cancer to one of the following four treatment arms 已经完成的组间临床试验0089（INT-0089​）将3,794例高危II期或III期结肠癌患者随机分配至四个治疗组
s184 Sentence Dukes B is a composite of better (T3, N0, M0) and worse (T4, N0, M0) prognostic groups, as is Dukes C (any T, N1, M0 and any T, N2, M0) ​Dukes B级包含了预后较好（T3, N0, M0）和预后较差（T4, N0, M0）组，Dukes C级亦然（任何T, N1, M0 与任何T, N2, M0 ）
s185 Sentence Many other prognostic markers have been evaluated retrospectively for patients with colon cancer, though most, including allelic loss of chromosome 18q or thymidylate synthase expression, have not been prospectively validated 结肠癌的回顾性研究还评价了一些其他预后相关标记物，例如染色体18q的等位基因缺失、胸苷酸合成酶的表达等，但多数未经前瞻性研究确认
s186 Sentence Racial differences in overall survival after adjuvant therapy have been observed, without differences in disease-free survival, suggesting that comorbid conditions play a role in survival outcome in different patient populations 辅助治疗后不同人种的总生存率存在差异，但无病生存率无差异，提示合并症可能与不同人种的生存结果相关
s187 Sentence Adjuvant radiation therapy has no current standard role in the management of patients with colon cancer following curative resection, although it may have a role for patients with residual disease 对于根治术后的结肠癌患者，目前标准治疗方案并不包括辅助放疗，尽管辅助放疗可能对病灶残留的患者有效
s188 Sentence Microsatellite instability, also associated with HNPCC, has been associated with improved survival independent of tumor stage in a population-based series of 607 patients younger than 50 years with colorectal cancer 一项基于人群调查的研究显示，在 607例小于50岁的结直肠癌患者中，与HNPCC相关的微卫星不稳定与良好预后相关，但与分期无关
s189 Sentence The V and L classifications should be used to identify the presence or absence of vascular or lymphatic invasion whereas the PN site-specific factor should be used for perineural invasion V和L分类用于标注是否存在血管和淋巴浸润，部位特异性因子PN则用于描述神经侵犯
s190 Sentence Further studies are required to evaluate this treatment approach and to determine if more effective systemic combination chemotherapy alone may provide similar results compared with hepatic intra-arterial therapy plus systemic treatment 此治疗方法的有效性需要进行更多临床研究评估，以对比单独使用更有效力的全身联合化疗的临床结局是否与肝动脉内化疗联合全身化疗类似
s191 Sentence For patients with hepatic metastasis considered to be resectable, a negative margin resection resulted in 5-year survival rates of 25% to 40% in mostly nonrandomized studies, such as the NCCTG-934653 trial 对于可切除肝转移患者，多数非随机临床研究（如NCCTG-934653）显示，术后切缘阴性者5年生存率可达25%至40%
s192 Sentence The Mayo Clinic or North Central Cancer Treatment Group (NCCTG) regimen (5-FU and low-dose leucovorin): Bolus 5-FU (450 mg/m2 )-leucovorin (20 mg/m2 ) administered daily for 5 days every 28 days 梅奥诊所或美国北部癌症治疗中心协作组织（NCCTG）方案（5FU联合低剂量左旋咪唑）：静脉推注5-FU（450mg/ m2）与亚叶酸（20mg/ m2），每天1次，每28天给药5天
s193 Sentence The role of laparoscopic techniques in the treatment of colon cancer was examined in a multicenter, prospective, randomized trial ( NCCTG-934653 , now closed) comparing laparoscopic-assisted colectomy (LAC) with open colectomy 一项多中心前瞻性随机临床试验（NCCTG-934653）在872例患者中比较了腹腔镜辅助结肠切除术（LAC）和开腹结肠切除术的疗效
s194 Sentence Replaced nodes should be counted separately as positive nodes in the N category, whereas discontinuous spread or venous invasion should be classified and counted in the site-specific factor category Tumor Deposits 被取代的淋巴结应根据N分期记作独立的阳性淋巴结，而不连续转移、静脉浸润则根据肿瘤特定部位记录为分类因子
s195 Sentence The role of laparoscopic techniques in the treatment of colon cancer was examined in a multicenter, prospective, randomized trial ( NCCTG-934653 , now closed) comparing laparoscopic-assisted colectomy (LAC) to open colectomy 一项多中心前瞻性随机临床试验（NCCTG-934653）在872例患者中比较了腹腔镜辅助结肠切除术（LAC）和开腹结肠切除术的疗效
s196 Sentence A second trial preoperatively randomly assigned 109 patients who had one to three potentially resectable colorectal hepatic metastases to either no further therapy or postoperative hepatic arterial floxuridine plus systemic 5-FU 另一项临床研究招募了109例有1-3处潜在可切除结肠癌肝转移瘤患者，术前所有患者分配至两组，一组在术后不接受其他治疗，另一组术后接受肝动脉氟尿苷联合全身5-FU化疗
s197 Sentence Studies have indicated that the number of lymph nodes involved affects prognosis; patients with one to three involved nodes have a significantly better survival than those with four or more involved nodes 相关研究显示，受累淋巴结数量影响预后；1-3枚淋巴结受累患者的生存期优于4枚或更多淋巴结受累的患者
s198 Sentence The FUFOX regimen: Oxaliplatin (50 mg/m2 ) plus leucovorin (500 mg/m2 ) plus 5-FU (2,000 mg/m2 ) as a 22-hour continuous infusion on days 1, 8, 22, and 29 every 36 days FUFOX化疗方案：第1、8、22、29天使用奥沙利铂（50mg/m2）、亚叶酸（500mg/m2）和5-FU（2,000mg/m2），连续输液22小时，每36天重复一次
s199 Sentence The impact of such monitoring on overall mortality of patients with recurrent colon cancer, however, is limited by the relatively small proportion of patients in whom localized, potentially curable metastases are found 但由于具有局限、潜在可治愈性转移灶的患者比例较低，定期监测降低复发性结肠癌患者死亡率的效果有限
s200 Sentence The OPUS study sought to evaluate the effect of adding cetuximab to first-line treatment with a FOLFOX regimen in an open-labeled, randomized, multicenter, phase II study of patients with EGFR-expressing metastatic colorectal cancer OPUS是一项开放性多中心II期随机临床研究，旨在评估FOLFOX一线治疗中增加西妥昔单抗对表达EGFR的转移性结直肠癌患者的作用
s201 Sentence Median PFS was 5.7 months for patients who received bevacizumab plus chemotherapy and 4.1 months for those who received chemotherapy without bevacizumab (HR, 0.68; 95% CI, 0.59–0.78; unstratified log-rank test, P < .0001) 含贝伐单抗化疗组的中位PFS为5.7月，不含贝伐单抗化疗组的中位PFS则为4.1个月（HR，0.68；95%CI，0.59-0.78；非分层log-rank检验P<0.0001）
s202 Sentence Several trials have analyzed the activity and toxic effects of various 5-FU-leucovorin regimens using different doses and administration schedules and showed essentially equivalent results with a median survival time in the 12-month range 一些临床试验分析了不同的5-FU-亚叶酸治疗方案，对比了不同剂量和给药方案的有效性与毒性，研究显示各项化疗方案疗效基本相当，中位生存时间12个月左右
s203 Sentence Median OS was 11.2 months for patients who received bevacizumab plus chemotherapy and 9.8 months for patients who received chemotherapy without bevacizumab (HR, 0.81; 95% CI, 0.69–0.94; unstratified log-rank test, P = .0062) 含贝伐单抗化疗组的中位OS为11.2个月，不含贝伐单抗化疗组的中位OS为9.8个月（HR，0.81；95%CI，0.69-0.94；非分层log-rank检验P=0.0062）
s204 Sentence The IFL (or Saltz) regimen (irinotecan, 5-FU, and leucovorin): Irinotecan (125 mg/m2 ), 5-FU (500 mg/m2 ) IV bolus, and leucovorin (20 mg/m2 ) IV bolus administered weekly for 4 out of 6 weeks IFL（又名Saltz）化疗方案（伊立替康、5-FU和亚叶酸）：每周行伊立替康（125mg/m2）输液，静脉推注5-FU（500mg/m2）和亚叶酸（20mg/m2），共四周，每6周重复一次
s205 Sentence In addition, multiple studies with multiagent chemotherapy have demonstrated that patients with metastatic disease isolated to the liver, which historically would be considered unresectable, can occasionally be made resectable after the administration of chemotherapy 此外，多项多药联合化疗临床研究显示，一些既往诊断为无法手术切除的孤立肝转移者经过化疗偶可转化为可手术切除
s206 Sentence In clinical trials, panitumumab demonstrated efficacy as a single agent or in combination therapy, which was consistent with the effects on PFS and OS with cetuximab. There appears to be a consistent class effect 临床试验显示，帕尼单抗单药或联合用药对PFS和OS的作用与西妥昔单抗一致，疑为一致性类效应
s207 Sentence Patterns-of-care analyses and single-institution retrospective reviews suggest a role for radiation therapy in certain high-risk subsets of colon cancer patients (e.g., T4, tumor location in immobile sites, local perforation, obstruction, and residual disease postresection) 治疗模式分析和单中心回顾性研究指出，放疗对于某些高风险结肠癌患者（例如T4肿瘤、肿瘤位于非移动部位、局部穿孔、梗阻和术后残余病灶）有一定作用
s208 Sentence The Roswell Park or National Surgical Adjuvant Breast and Bowel Project (NSABP) regimen (5-FU and high-dose leucovorin): Bolus 5-FU (500 mg/m^2 )-leucovorin (500 mg/m^2 ) administered weekly for 6 consecutive weeks every 8 weeks Roswell-Park方案或美国乳腺与肠道外科辅助治疗研究组（NSABP）方案（5-FU联合高剂量左旋咪唑）：静脉推注5-FU（500mg/ m2）与亚叶酸（500mg/ m2），每周1次，每8周连续给药6周
s209 Sentence Patients with HNPCC reportedly have better prognoses in stage-stratified survival analysis than patients with sporadic colorectal cancer, but the retrospective nature of the studies and possibility of selection factors make this observation difficult to interpret 据报道，当按肿瘤分期分层后，HNPCC患者预后均优于散发性结直肠癌患者，但由于回顾性研究的内在特点以及可能存在的选择性偏倚，导致难以解读这些研究结果
s210 Sentence Patients who received aflibercept plus FOLFIRI had a significantly improved OS relative to placebo plus FOLFIRI (HR, 0.817; 95.34% CI, 0.713–0.937; P = .0032) with median survival times of 13.50 months versus 12.06 months, respectively 相较于安慰剂联合FOLXFIRI组，阿柏西普联合FOLFIRI化疗组的OS有显著改善（HR，0.817；95.34%CI，0.713-0.937；P=0.0032），阿柏西普和安慰剂组的中位生存时间分别为13.50月和12.06月
s211 Sentence Stage 0 colon cancer is the most superficial of all the lesions and is limited to the mucosa without invasion of the lamina propria. Because of its superficial nature, the surgical procedure may be limited 0期结肠癌的病变最浅表，局限于粘膜且未浸润固有层，因此手术范围可以较为局限
s212 Sentence Because cetuximab affects tyrosine kinase signaling at the surface of the cell membrane, tumors with mutations causing activation of the pathway downstream of the EGFR, such as KRAS mutations, are not sensitive to its effects 西妥昔单抗的作用机理是在细胞膜表面干扰酪氨酸激酶的信号通路，故导致EGFR下游通路激活的肿瘤突变，如KRAS突变，则对西妥昔单抗不敏感
s213 Sentence The FUOX regimen: Continuous infusion 5-FU (2,250 mg/m2 ) during 48 hours on days 1, 8, 15, 22, 29 and 36 plus oxaliplatin (85 mg/m2 ) on days 1, 15, and 29 every 6 weeks FUOX化疗方案：第1、8、15、22、29和36天5-FU（2,250mg/m2）连续输液48小时，第1、15、29天奥沙利铂输液（85mg/m2），每6周重复一次
s214 Sentence This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about the treatment of colon cancer. It is intended as a resource to inform and assist clinicians who care for cancer patients 本PDQ癌症信息总结为医疗专业人士提供综合性、经同行审核的结肠癌治疗相关循证信息，旨在教育并帮助为癌症患者提供医疗服务的临床医师
s215 Sentence Patients with hepatic metastases that are deemed unresectable will occasionally become candidates for resection if they have a good response to chemotherapy. These patients have 5-year survival rates similar to patients who initially had resectable disease 初始肝转移不可切除者如果化疗效果理想，偶可外科切除转移灶，术后5年生存率与初始转移灶可切除者相当
s216 Sentence Based on these data, the American Society of Clinical Oncology issued a guideline stating “direct evidence from randomized controlled trials does not support the routine use of adjuvant chemotherapy for patients with stage II colon cancer.” 基于这些数据，美国临床肿瘤学会制定的指南指出“随机对照临床试验的直接证据并不支持II期结肠癌患者常规使用辅助化疗”
s217 Sentence This recommendation takes into consideration that the number of lymph nodes examined is a reflection of the aggressiveness of lymphovascular mesenteric dissection at the time of surgical resection and the pathologic identification of nodes in the specimen 这一建议既考虑到淋巴血管受累程度与淋巴结数量相关，也考虑了病理标本中淋巴结检查的实际情况
s218 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage III colon cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 现招募III期结肠癌​患者的美国临床试验请参见美国NCI癌症临床试验列表，可根据部位、药物、干预或其他标准进行筛选
s219 Sentence The Medical Research Council (MRC) ( COIN [NCT00182715] trial) sought to answer the question of whether adding cetuximab to combination chemotherapy with a fluoropyrimidine and oxaliplatin in first-line treatment for patients with first-line KRAS wild-type tumors was beneficial 医学研究委员会（MRC）（COIN[NCT00182715]临床试验）研究了以氟嘧啶和奥沙利铂联合化疗作为一线治疗时，增加西妥昔单抗是否能使KRAS基因野生型的肿瘤患者获益
s220 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage 0 colon cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 现招募0期结肠癌​患者的美国临床试验请参见美国NCI癌症临床试验列表，可根据部位、药物、干预或其他标准进行筛选
s221 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage II colon cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 现招募II期结肠癌​患者的美国临床试验请参见美国NCI癌症临床试验列表，可根据部位、药物、干预或其他标准进行筛选
s222 Sentence The Levamisole regimen (5-FU and levamisole): Bolus 5-FU (450 mg/m^2 per day) on days 1 to 5, then weekly 28 days later plus levamisole (50 mg) administered orally 3 times a day for 3 days every 2 weeks 左旋咪唑方案（5-FU联合左旋咪唑）：第1-5天静脉推注5-FU（每天450mg/ m2），此后每周给药一次，28天后加用左旋咪唑（50mg）口服每天3次，每2周3天
s223 Sentence The American Joint Committee on Cancer (AJCC) and a National Cancer Institute–sponsored panel recommended that at least 12 lymph nodes be examined in patients with colon and rectal cancer to confirm the absence of nodal involvement by tumor 美国癌症联合委员会（AJCC）和美国国家癌症研究所专家组建议对结直肠癌患者至少检查12枚淋巴结，以确认无淋巴结受累
s224 Sentence A meta-analysis of 1,000 stage II patients whose experience was amalgamated from a series of trials indicates a 2% advantage in disease-free survival at 5 years when adjuvant therapy–treated patients treated with 5-FU-leucovorin are compared with untreated controls 对来自一系列临床试验的1,000例II期患者行荟萃分析，结果显示接受5-FU-亚叶酸辅助化疗的患者相比较未接受该辅助化疗的对照组患者而言，其5年无病生存率提高2%
s225 Sentence Subsequently, in a randomized phase III study, patients with untreated stage IV colorectal cancer were randomly assigned in a 2 × 2 factorial design to CAPOX versus FOLFOX4, then to bevacizumab versus placebo. PFS was the primary endpoint 后续的一项III期随机临床研究将初治的IV期结直肠癌患者随机分组，采用2×2因素设计，先接受CAPOX或FOLFOX4方案治疗，后接受贝伐单抗或安慰剂治疗，研究主要终点为PFS
s226 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage I colon cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 现招募I期结肠癌​患者的美国临床试验请参见美国NCI癌症临床试验列表，可根据部位、药物、干预或其他标准进行筛选
s227 Sentence Similarly, the addition of panitumumab to a regimen of FOLFOX/bevacizumab resulted in a worse PFS and worse toxicity compared to a regimen of FOLFOX/bevacizumab alone in patients not selected for KRAS mutation in metastatic colon cancer (11.4 months vs 类似地，在未检测KRAS基因突变情况的转移性结直肠癌患者中，与单独使用FOLFOX/贝伐单抗相比，在FOLFOX/贝伐单抗化疗方案中加入帕尼单抗对PFS有不良影响，且毒性增强
s228 Sentence The Cancer Care Ontario Practice Guideline Initiative Gastrointestinal Cancer Disease Site Group undertook a meta-analysis of the English language–published literature consisting of randomized trials in which adjuvant chemotherapy was compared with observation for patients with stage II colon cancer 安大略省癌症实践指南组织胃肠肿瘤组对用英文发表的随机临床试验进行了荟萃分析，所有纳入研究均以II期结肠癌患者辅助化疗与单纯观察作为研究对象
s229 Sentence Although only a small proportion of patients with hepatic metastases are candidates for surgical resection, advances in tumor ablation techniques and in both regional and systemic chemotherapy administration provide for a number of treatment options. These include the following: 虽然只有小部分肝转移患者适合手术切除，但肿瘤消融、局部和全身化疗的发展提供了更多的治疗选择，包括：
s230 Sentence Revised text to state that a meta-analysis of the randomized studies, which were all done in the era when only fluoropyrimidines were available for systemic therapy, did not demonstrate a survival advantage (cited Mocellin et al. as reference 40) 修改内容​：根据对仅有氟嘧啶作为全身治疗时期的多篇随机临床研究进行的荟萃分析，该治疗未显示生存获益（引用Mocellinetal.，参考文献40）
s231 Sentence A satellite peritumoral nodule in the pericolorectal adipose tissue of a primary carcinoma without histologic evidence of residual lymph node in the nodule may represent discontinuous spread, venous invasion with extravascular spread (V1/2), or a totally replaced lymph node (N1/2) 结肠周围脂肪组织中发现的瘤周卫星结节，且无残留淋巴结的组织学证据，可能为不连续转移、静脉浸润与血管外播散（V1/2）、或被完全取代的淋巴结（N1/2）
s232 Sentence Added text to state that in clinical trials, panitumumab demonstrated efficacy as a single agent or in combination therapy, which was consistent with the effects on PFS and overall survival with cetuximab; there appears to be a consistent class effect 添加内容：在临床试验中，帕尼单抗单药治疗或联合其他药物治疗对对PFS和OS的作用与西妥昔单抗一致，疑为一致性类效应
s233 Sentence Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with stage IV colon cancer and recurrent colon cancer. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria 现招募IV期结肠癌和复发性结肠癌​患者的美国临床试验请参见美国NCI癌症临床试验列表，可根据部位、药物、干预或其他标准进行筛选
s234 Sentence A multicenter European study compared capecitabine (1,250 mg/m^2 ) administered twice daily for days 1 to 14, then given every 21 days for eight cycles against the Mayo Clinic schedule of 5-FU and low-dose leucovorin for patients with stage III colon cancer 一项欧洲多中心临床研究招募了III期结肠癌患者，对比了卡培他滨和梅奥诊所方案化疗的效果，其中卡培他滨（1,250mg/ m2）第1-14天每日两次给药，此后每21天一次，共8程；另一组为梅奥诊所方案，即5-FU联合低剂量亚叶酸
s235 Sentence Such observations led to the development of a phase III randomized intergroup study designed to test the benefit of adding radiation therapy to surgery and chemotherapy with 5-FU-levamisole for selected high-risk colon cancer patients (e.g., T4; or T3, N1–N2 ascending and/or descending colon) 基于上述观察结果，一项随机组间III期临床试验以某些高风险结肠癌患者（例如分期为T4期；或是升结肠和（或）降结肠的分期为T3, N1-N2的肿瘤）作为研究对象，进行了在手术和5-FU-左旋咪唑联合化疗基础上进行放疗的疗效观察
s236 Sentence While combined modality therapy with chemotherapy and radiation therapy has a significant role in the management of patients with rectal cancer (below the peritoneal reflection), the role of adjuvant radiation therapy for patients with colon cancer (above the peritoneal reflection) is not well defined 化疗联合放疗对治疗直肠癌（腹膜反折以下）有非常重要的意义，而辅助放疗在结肠癌（ 腹膜反折以上）治疗中的作用尚未确定
s237 Sentence When 5-FU was the only active chemotherapy drug, trials in patients with locally advanced, unresectable, or metastatic disease demonstrated partial responses and prolongation of the time-to-progression (TTP) of disease as well as improved survival and quality of life for patients receiving chemotherapy, compared with the best supportive care 在5-FU是唯一有效化疗药物的时代，使用5-FU治疗局部晚期、无法切除或转移性病灶的临床试验中，相比最佳支持治疗组，化疗后患者的缓解率、疾病进展时间（TTP）、生存时间和生活质量都有改善
s238 Sentence Although subgroups of patients with stage II colon cancer may be at higher-than-average risk for recurrence (including those with anatomic features such as tumor adherence to adjacent structures, perforation, complete obstruction), evidence is inconsistent that adjuvant 5-fluorouracil (5-FU)–based chemotherapy is associated with an improved OS compared with surgery alone 尽管一些II期结肠癌患者（如肿瘤与周围结构粘连、穿孔、完全性梗阻等）复发率高于平均水平，但术后辅以5-氟尿嘧啶（5-FU）为基础的辅助化疗是否能够改善OS的临床证据仍不一致
s239 Sentence Added text to state that the OPUS study sought to evaluate the effect of adding cetuximab to first-line treatment with a FOLFOX regimen in an open-labeled, randomized, multicenter, phase II study of patients with EGFR-expressing metastatic colorectal cancer (cited Bokemeyer et al. as reference 69 and level of evidence 1iiD) 添加内容：OPUS是一项开放性多中心II期随机临床研究，旨在评估FOLFOX一线治疗中增加西妥昔单抗对表达EGFR的转移性结直肠癌患者的作用（引用Bokemeyer et al.，参考文献69，证据等级1iiD）
s240 Sentence In the 2,246 patients with resected stage II or stage III colon cancer in the completed Multicenter International Study of Oxaliplatin/5-Fluorouracil/Leucovorin in the Adjuvant Treatment of Colon Cancer ( MOSAIC [NCT00275210]) study, the toxic effects and efficacy of FOLFOX4 were compared with the same 5-FU-leucovorin regimen without oxaliplatin administered for 6 months 已经完成的国际多中心研究（MOSAIC[NCT00275210]）共招募了2,246例结肠癌术后患者，研究目的是观察奥沙利铂/5-FU/亚叶酸对于II期或III期结肠癌的辅助化疗效果，研究对比了6个月FOLFOX4方案和不含奥沙利铂的同剂量5-FU-亚叶酸方案的毒性和有效性
s241 Sentence Investigators from the National Surgical Adjuvant Breast and Bowel Project (NSABP) have indicated that the reduction in risk of recurrence by adjuvant therapy in patients with stage II disease is of similar magnitude to the benefit seen in patients with stage III disease treated with adjuvant therapy, though an OS advantage has not been established 美国乳腺与肠道外科辅助治疗研究组（NSABP）的调查显示，II期结肠癌患者辅助化疗后复发率的降低程度与III期结肠癌辅助化疗后的获益相似，尽管未证明OS获益
s242 Sentence Added text to state that because cetuximab affects tyrosine kinase signaling at the surface of the cell membrane, tumors with mutations causing activation of the pathway downstream of the EGFR are not sensitive to its effects; the addition of cetuximab to multiagent chemotherapy improves survival in patients with colon cancers that lack a KRAS mutation 添加内容：西妥昔单抗的作用机理是在细胞膜表面干扰酪氨酸激酶的信号通路，故当肿瘤突变导致EGFR下游通路激活时，肿瘤对西妥昔单抗不敏感；在多药联合化疗中加入西妥昔单抗可以改善无KRAS突变的结直肠癌患者的生存时间
s243 Sentence A trial of hepatic arterial floxuridine and dexamethasone plus systemic fluorouracil (5-FU) and leucovorin compared with systemic 5-FU plus leucovorin alone showed improved 2-year progression-free survival (PFS) (57% vs 42%, P = .07) and overall survival (OS) (86% vs 72%, P = .03) but did not show a significant statistical difference in median survival, compared with systemic 5-FU therapy alone 一项临床研究在进行全身5-FU和亚叶酸化疗的基础上，观察了加用肝动脉氟尿苷与地塞米松化疗的疗效观察，研究显示肝动脉氟尿嘧啶与地塞米松联合全身5-FU和亚叶酸组的2年无进展生存率（PFS）（分别为57%和42%，P=0.07）和总生存率（OS）（分别为86%和72%，P=0.03）相比于单独全身5-FU和亚叶酸组均有改善，但是两组中位生存时间无统计学差异
s244 Sentence Because of the frequency of the disease, ability to identify high-risk groups, slow growth of primary lesions, better survival of patients with early-stage lesions, and relative simplicity and accuracy of screening tests, screening for colon cancer should be a part of routine care for all adults aged 50 years and older, especially for those with first-degree relatives with colorectal cancer 由于结肠癌具有发病率高、明确的高危人群、原发病变生长缓慢、早期患者预后佳、相对简单准确的筛查方式等特点，推荐所有50岁以上成年人进行常规结肠癌筛查，尤其是具有一级家属结直肠癌病史的人群
s245 Sentence The FOLFOX6 regimen (oxaliplatin, leucovorin, and 5-FU): Oxaliplatin (85–100 mg/m^2 ) administered as a 2-hour infusion on day 1; leucovorin (400 mg/m2 ) administered as a 2-hour infusion on day 1; followed by a loading dose of 5-FU (400 mg/m2 ) IV bolus on day 1, then 5-FU (2,400–3,000 mg/m2 ) administered via ambulatory pump for a period of 46 hours every 2 weeks FOLFOX6化疗方案（奥沙利铂、亚叶酸和5-FU）：第1天奥沙利铂（85-100mg/m2）输液2小时，亚叶酸（400mg/m2）输液2小时， 并静脉用负荷剂量5-FU（400mg/m2），此后46小时静脉泵入5-FU（2,400-3,000mg/m2），每两周重复一次
s246 Sentence The FOLFIRI regimen (folic acid, 5-FU, and irinotecan): Irinotecan (180 mg/m2 ) administered as a 2-hour infusion on day 1; leucovorin (400 mg/m2 ) administered as a 2-hour infusion on day 1; followed by a loading dose of 5-FU (400 mg/m2 ) IV bolus administered on day 1, then 5-FU (2,400–3,000 mg/m2 ) administered via ambulatory pump for a period of 46 hours every 2 weeks FOLFIRI化疗方案（叶酸、5-FU和伊立替康）：第1天伊立替康（180mg/m2）输液2小时，亚叶酸（400mg/m2）输液2小时，并静脉用负荷剂量5-FU（400mg/m2），此后连续46小时静脉泵入5-FU（2,400-3,000mg/m2），每两周重复一次
s247 Sentence The Arbeitsgemeinschaft Internische Onkologie (AIO) or German AIO regimen (folic acid, 5-FU, and irinotecan): Irinotecan (100 mg/m2 ) administered as a 2-hour infusion on day 1; leucovorin (500 mg/m2 ) administered as a 2-hour infusion on day 1; followed by 5-FU (2,000 mg/m^2 ) intravenous (IV) bolus via ambulatory pump administered for a period of 24 hours on a weekly basis four times a year (52 weeks) 德国肿瘤医学协会（AIO）化疗方案（叶酸、5-FU与伊立替康）：第1天伊立替康（100mg/m2）输液2小时和亚叶酸（500mg/m2）输液2小时，此后每年（共52周）4周，每周一次静脉（IV）泵入5-FU（2,000mg/m2）24小时
s248 Sentence The FOLFOX4 regimen (oxaliplatin, leucovorin, and 5-FU): Oxaliplatin (85 mg/m^2 ) administered as a 2-hour infusion on day 1; leucovorin (200 mg/m^2 ) administered as a 2-hour infusion on day 1 and day 2; followed by a loading dose of 5-FU (400 mg/m^2 ) IV bolus, then 5-FU (600 mg/m^2 ) administered via ambulatory pump for a period of 22 hours on day 1 and day 2 every 2 weeks FOLFOX4化疗方案（奥沙利铂、亚叶酸和5-FU）：第1天奥沙利铂（85mg/m2）输液2小时；第1天和第2天亚叶酸（200mg/m2）输液各2小时；并静脉用负荷剂量5-FU（400mg/m2），此外，第1天和第2天各连续22小时静脉泵入5-FU（600mg/m2），每两周重复一次
s249 Sentence The Douillard regimen (folic acid, 5-FU, and irinotecan): Irinotecan (180 mg/m^2 ) administered as a 2-hour infusion on day 1; leucovorin (200 mg/m^2 ) administered as a 2-hour infusion on day 1 and day 2; followed by a loading dose of 5-FU (400 mg/m^2 ) IV bolus, then 5-FU (600 mg/m^2 ) via ambulatory pump administered for a period of 22 hours on day 1 and day 2 every 2 weeks Douillard化疗方案（叶酸、5-FU与伊立替康）：第1天伊立替康（180mg/m2）输液2小时；第1天和第2天亚叶酸（200mg/m2）输液2小时；第1天输液后静脉用负荷剂量5-FU（400mg/m2）一次，随后第1天和第2天各连续22小时静脉泵入5-FU（600mg/m2），每两周重复一次
s250 Sentence The FOLFOX4 regimen (oxaliplatin, leucovorin, and fluorouracil [5-FU]): Oxaliplatin (85 mg/m^2 ) administered as a 2-hour infusion on day 1; leucovorin (200 mg/m^2 ) administered as a 2-hour infusion on day 1 and day 2; followed by a loading dose of 5-FU (400 mg/m^2 ) intravenous bolus, then 5-FU (600 mg/m^2 ) administered via ambulatory pump for a period of 22 hours on day 1 and day 2 every 2 weeks FOLFOX4方案（奥沙利铂、亚叶酸联合氟尿嘧啶[5-FU]）：第1天行奥沙利铂（85mg/m2）输液，时间2小时；第1天与第2天行亚叶酸（200mg/m2）输液，时间各2小时；输液后静脉推注负荷剂量5-FU（400mg/m2），随后第1天和第2天泵入5-FU（600mg/m2），时间各22小时；每两周重复上述化疗方案
s251 Sentence Added text to state that a major question was whether the use of bevacizumab after first-line therapy was warranted when bevacizumab was used as a component of first-line therapy; added that at the 2012 American Society of Clinical Oncology Annual Meeting data was presented from a randomized, controlled trial of patients with metastatic colorectal cancer who were randomly assigned to chemotherapy without bevacizumab or chemotherapy with bevacizumab (cited Arnold et al. as reference 62 and level of evidence 1iiA) 添加内容​：当贝伐单抗作为一线疗法的一部分时，一线治疗后是否有理由继续使用贝伐单抗尚有争议，并添加了来自2012年美国临床癌症肿瘤协会年会的数据，一项随机对照临床试验招募了转移性结直肠癌患者，将这些患者随机分组，接受含贝伐单抗化疗和不含贝伐单抗的化疗方案（引用Arnoldetal.，参考文献62，证据等级1iiA）
s252 Sentence Direct invasion in T4 includes invasion of other organs or other segments of the colorectum as a result of direct extension through the serosa, as confirmed on microscopic examination (e.g., invasion of the sigmoid colon by a carcinoma of the cecum) or, for cancers in a retroperitoneal or subperitoneal location, direct invasion of other organs or structures by virtue of extension beyond the muscularis propria (i.e., respectively, a tumor on the posterior wall of the descending colon invading the left kidney or lateral abdominal wall; or a mid or distal rectal cancer with invasion of prostate, seminal vesicles, cervix, or vagina) T4直接浸润包括：肿瘤穿透浆膜层直接侵犯其他器官或结直肠的其他部分，并由镜检确认（如：盲肠肿瘤侵犯乙状结肠）；或腹膜后、腹膜下的肿瘤穿透固有肌层直接浸润其他器官或结构（如降结肠后壁肿瘤侵犯左肾或侧腹壁、中远端直肠肿瘤侵犯前列腺、精囊、宫颈或者阴道）