Adjuvant portal-vein infusion of fluorouracil and heparin in colorectal cancer: A randomised trial

Background. There is conflicting evidence on the efficacy of regional adjuvant chemotherapy, via portal-vein infusion (PVI), after resection of colorectal cancer. We undertook a randomised controlled multicentre trial to investigate the efficacy of PVI (500 mg/m2 fluorouracil plus 5000 IU heparin daily for 7 days). Methods. 1235 of about 1500 potentially eligible patients were randomly assigned surgery plus PVI or surgery alone (control). The patients were followed up for a median of 63 months, with yearly screening for recurrent disease. The primary endpoint was survival; analyses were by intention to treat. Findings. 619 patients in the control group and 616 in the PVI group met eligibility criteria. 164 (26%) control-group patients and 173 (28%) PVI-group patients died. 5-year survival did not differ significantly between the groups (73 vs 72%; 95% CI for difference -6 to 4). The control and PVI groups were also similar in terms of disease-free survival at 5 years (67 vs 65%) and the number of patients with liver metastases (79 vs 77%). Interpretation. PVI of fluorouracil, at a dose of 500 mg/m2 for 7 days, cannot be recommended as the sole adjuvant treatment for high-risk colorectal cancer after complete surgical excision. However, these results cannot eliminate a small benefit when PVI is used at a higher dosage or in combination with mitomycin.

Spin three gauge theory revisited

We study the problem of consistent interactions for spin-3 gauge fields in flat spacetime of arbitrary dimension 3$">n>3. Under the sole assumptions of Poincaré and parity invariance, local and perturbative deformation of the free theory, we determine all nontrivial consistent deformations of the abelian gauge algebra and classify the corresponding deformations of the quadratic action, at first order in the deformation parameter. We prove that all such vertices are cubic, contain a total of either three or five derivatives and are uniquely characterized by a rank-three constant tensor (an internal algebra structure constant). The covariant cubic vertex containing three derivatives is the vertex discovered by Berends, Burgers and van Dam, which however leads to inconsistencies at second order in the deformation parameter. In dimensions 4$">n>4 and for a completely antisymmetric structure constant tensor, another covariant cubic vertex exists, which contains five derivatives and passes the consistency test where the previous vertex failed. © SISSA 2006.