The Clinical efficacy of Fluorouracil/leucovorin and Oxaliplatin plus Capecitabine Chemotherapy on advanced Colorectal Cancer_West China Medical Journal

Authors：

ZHANG Xi , JIA Xunchao.

Department of Oncology, People’s Hospital of Ya’an, Ya’an, Sichuan 625000, P. R. China;

Corresponding?author：

Keywords：

結直腸癌; 化學療法; 草酸鉑聯合卡培他濱方案; 草酸鉑聯合氟尿嘧啶/亞葉酸鈣方案; 療效

DOI：

10.7507/1002-0179.20130119

Video：

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目的　比較草酸鉑聯合氟尿嘧啶/亞葉酸鈣（FOLFOX4）與草酸鉑聯合卡培他濱（XELOX）治療晚期結直腸癌的臨床療效。方法　將2007年1月－2011年12月收治的58例轉移或復發晚期結直腸癌患者按照化學療法（化療）方案的不同分為兩組，其中FOLFOX4組28例（男性患者占57.1%，平均年齡56.3歲），XELOX組30例（男性患者占63.3%，平均年齡57.8歲）。所有患者療程不少于2個化療周期，評價指標為病情緩解率和化療藥物的毒副作用。結果　FOLFOX4組完全緩解率（CR）和部分緩解率（PR）分別為10.7%（3/28）和32.1%（9/28），總有效率為42.8%（12/28）；XELOX組CR和PR率分別為13.3%（4/30）和30.0%（9/30），總有效率為43.3%（13/30），兩組總有效率差異無統計學意義（P=0.971）。XELOX組有10.0%（3/30）和16.7%（5/30）的患者分別出現中性粒細胞降低和神經毒性，但均顯著低于FOLFOX4組[39.3%（11/28）、43.3%（13/30）]（P=0.009，0.014）。XELOX組手足綜合癥發生率明顯高于FOLFOX4組[40.0%（12/30）、14.5（4/28），P=0.029），但程度較輕, 主要為Ⅰ～Ⅱ度。結論　XELOX與FOLFOX4化療方案治療晚期結直腸癌患者的療效相似，但XELOX化療方案毒副反應相對較小。

Citation： ZHANG Xi,JIA Xunchao.. The Clinical efficacy of Fluorouracil/leucovorin and Oxaliplatin plus Capecitabine Chemotherapy on advanced Colorectal Cancer. West China Medical Journal, 2013, 28(3): 373-376. doi: 10.7507/1002-0179.20130119 Copy

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10.	Díaz-Rubio E, Evans TR, Tabemero J, et al. Capecitabine (Xeloda) in combination with oxaliplatin: a phase I, dose-escalation study in patients with advanced or metastatic solid tumors[J]. Ann Oncol, 2002, 13(4): 558-565.
11.	Walko CM, Lindley C. Capecitabine: a review[J]. Clin Ther, 2005, 27(1): 23-44.
12.	Patel PA. Evolution of 5-fluorouracil-based chemoradiation in the management of rectal cancer[J]. Anticancer Drugs, 2011, 22(4): 311-316.
13.	Davies JM, Goldberg RM. Treatment of metastatic colorectal cancer[J]. Semin Oncol, 2011, 38(4): 552-560.
14.	Madi A, Fisher D, Wilson RH, et al. Oxaliplatin/capecitabine vs oxaliplatin/infusional 5-FU in advanced colorectal cancer: the MRC COIN trial[J]. Br J Cancer, 2012, 107(7): 1037-1043.
15.	Salazar R, Navarro M, Losa F, et al. Phase Ⅱ study of preoperative radiotherapy and concomitant weekly intravenous oxaliplatin combined with oral capecitabine for stages Ⅱ-Ⅲ rectal cancer[J]. Clin Transl Oncol, 2012, 14(8): 592-598.
16.	Wehler TC, Cao Y, Galle PR, et al. Combination therapies with oxaliplatin and oral capecitabine or intravenous 5-FU show similar toxicity profiles in gastrointestinal carcinoma patients if hand-food syndrome prophylaxis is performed continuously[J]. Oncol Lett, 2012, 3(6): 1191-1194.

1. 　Jemal A, Siegel R, Ward E, et al. Cancer statistics [J]. CA Cancer J Clin, 2007, 57(1): 43-66.
2. 　萬德森. 臨床腫瘤學[M]. 2版. 北京：科學出版社, 2005: 348-349.
3. 　徐瑞華, 陳曉勤. 結腸癌輔助化學治療的共識與爭議[J]. 內科理論與實踐, 2009, 4(1): 32-36.
4. 　Sternberg A, Sibirsky O, Cohen D, et al. Validation of a new classification system for curatively resected colorectal adenocarcinoma[J]. Cancer, 1999, 86(5): 782-792.
5. 　Gravalos C, Salut A, García-Girón C, et al. A randomized phase II study to compare oxaliplatin plus 5-fluorouracil and leucovorin (FOLFOX4) versus oxaliplatin plus raltitrexed (TOMOX) as first-line chemotherapy for advanced colorectal cancer[J]. Clin Transl Oncol, 2012, 14(8): 606-612.
6. 　孫燕，管忠震，金懋林，等. 奧沙利鉑單藥或與氟尿嘧啶-甲酰四氫葉酸聯合應用治療晚期大腸癌Ⅱ期臨床試用報告[J]. 癌癥, 1999, 18(3): 237-240.
7. 　Cassidy J, Tabernero J, Twelves C, et al. XELOX (capecitabine plus oxaliplatin): active first-line therapy for patients with metastatic colorectal cancer[J]. J Clin Oncol, 2004, 22(11): 2084-2091.
8. 　Chai H, Pan J, Zhang X, et al. ERCC1 C118T associates with response to FOLFOX4 chemotherapy in colorectal cancer patients in Han Chinese[J]. Int J Clin Exp Med, 2012, 5(2): 186-194.
9. 　Iqbal S, Lenz HJ. Integration of novel agents in the treatment of colorectal cancer[J]. Cancer Chemother Pharmacol, 2004, 54(Suppl 1): S32-S39.
10. 　Díaz-Rubio E, Evans TR, Tabemero J, et al. Capecitabine (Xeloda) in combination with oxaliplatin: a phase I, dose-escalation study in patients with advanced or metastatic solid tumors[J]. Ann Oncol, 2002, 13(4): 558-565.
11. 　Walko CM, Lindley C. Capecitabine: a review[J]. Clin Ther, 2005, 27(1): 23-44.
12. 　Patel PA. Evolution of 5-fluorouracil-based chemoradiation in the management of rectal cancer[J]. Anticancer Drugs, 2011, 22(4): 311-316.
13. 　Davies JM, Goldberg RM. Treatment of metastatic colorectal cancer[J]. Semin Oncol, 2011, 38(4): 552-560.
14. 　Madi A, Fisher D, Wilson RH, et al. Oxaliplatin/capecitabine vs oxaliplatin/infusional 5-FU in advanced colorectal cancer: the MRC COIN trial[J]. Br J Cancer, 2012, 107(7): 1037-1043.
15. 　Salazar R, Navarro M, Losa F, et al. Phase Ⅱ study of preoperative radiotherapy and concomitant weekly intravenous oxaliplatin combined with oral capecitabine for stages Ⅱ-Ⅲ rectal cancer[J]. Clin Transl Oncol, 2012, 14(8): 592-598.
16. 　Wehler TC, Cao Y, Galle PR, et al. Combination therapies with oxaliplatin and oral capecitabine or intravenous 5-FU show similar toxicity profiles in gastrointestinal carcinoma patients if hand-food syndrome prophylaxis is performed continuously[J]. Oncol Lett, 2012, 3(6): 1191-1194.

West China Medical Journal

The Clinical efficacy of Fluorouracil/leucovorin and Oxaliplatin plus Capecitabine Chemotherapy on advanced Colorectal Cancer

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