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：

结直肠癌; 化学疗法; 草酸铂联合卡培他滨方案; 草酸铂联合氟尿嘧啶/亚叶酸钙方案; 疗效

DOI：

10.7507/1002-0179.20130119

Video：

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目的　比较草酸铂联合氟尿嘧啶/亚叶酸钙（FOLFOX4）与草酸铂联合卡培他滨（XELOX）治疗晚期结直肠癌的临床疗效。方法　将2007年1月－2011年12月收治的58例转移或复发晚期结直肠癌患者按照化学疗法（化疗）方案的不同分为两组，其中FOLFOX4组28例（男性患者占57.1%，平均年龄56.3岁），XELOX组30例（男性患者占63.3%，平均年龄57.8岁）。所有患者疗程不少于2个化疗周期，评价指标为病情缓解率和化疗药物的毒副作用。结果　FOLFOX4组完全缓解率（CR）和部分缓解率（PR）分别为10.7%（3/28）和32.1%（9/28），总有效率为42.8%（12/28）；XELOX组CR和PR率分别为13.3%（4/30）和30.0%（9/30），总有效率为43.3%（13/30），两组总有效率差异无统计学意义（P=0.971）。XELOX组有10.0%（3/30）和16.7%（5/30）的患者分别出现中性粒细胞降低和神经毒性，但均显著低于FOLFOX4组[39.3%（11/28）、43.3%（13/30）]（P=0.009，0.014）。XELOX组手足综合症发生率明显高于FOLFOX4组[40.0%（12/30）、14.5（4/28），P=0.029），但程度较轻, 主要为Ⅰ～Ⅱ度。结论　XELOX与FOLFOX4化疗方案治疗晚期结直肠癌患者的疗效相似，但XELOX化疗方案毒副反应相对较小。

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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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. 　万德森. 临床肿瘤学[M]. 2版. 北京：科学出版社, 2005: 348-349.
3. 　徐瑞华, 陈晓勤. 结肠癌辅助化学治疗的共识与争议[J]. 内科理论与实践, 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. 　孙燕，管忠震，金懋林，等. 奥沙利铂单药或与氟尿嘧啶-甲酰四氢叶酸联合应用治疗晚期大肠癌Ⅱ期临床试用报告[J]. 癌症, 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

Abstract Full text Figures/Tables Video References Cited by

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