Clinical Observation of Treatment for Advanced Colorectal Cancer with S-1 Plus Oxaliplatin_West China Medical Journal

Authors：

LONG Jieran , HE Jianping , ZHU Wenyan , LIU Jiyan ,  YI Cheng , LUO Deyun , BI Feng , XU Feng

Department of Abdominal Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

YI Cheng, Email: btl-060@163.com

Keywords：

替吉奥; 奥沙利铂; 晚期结直肠癌

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目的　观察替吉奥胶囊联合奥沙利铂治疗晚期结直肠癌的近期疗效和毒性反应。方法　2011年5月－12月，将30例晚期结直肠癌患者根据体表面积来确定初始剂量，体表面积＜1.25 m2者，替吉奥胶囊40 mg/次，2次/d；体表面积1.25～1.50 m2者，替吉奥胶囊50 mg/次，2次/d；体表面积＞1.50 m2者，替吉奥胶囊60 mg/次，2次/d。早饭后和晚饭后分别口服1次，第1～4天服用奥沙利铂注射液 130 mg/ m2，静脉滴注，第1、21天重复，此为1个月周期。连用2周期后，按美国国立癌症研究所拟定的药物不良反应的分级评价标准3.0版本评价不良反应，按实体瘤治疗疗效评价标准评价疗效。结果　30例患者中，完全缓解1例（3.3%），部分缓解7例（23.3%），稳定12例（40%），进展10例（33.3%），疾病控制率为66.6%。不良反应主要是血液学毒性、胃肠道反应、皮肤色素沉着及外周神经毒性；1例Ⅳ度骨髓抑制，3例3度贫血，2例3度腹泻，2例3度皮肤色素沉着，2例3度恶心、呕吐，其余且均在Ⅰ～Ⅱ度骨髓抑制。结论　替吉奥胶囊联合奥沙利铂方案治疗晚期结直肠癌可获得较高的疾病控制率，不良反应可控。

Citation： LONG Jieran,HE Jianping,ZHU Wenyan,LIU Jiyan,YI Cheng,LUO Deyun,BI Feng,XU Feng. Clinical Observation of Treatment for Advanced Colorectal Cancer with S-1 Plus Oxaliplatin. West China Medical Journal, 2012, 27(5): 693-696. doi: Copy

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2.	Giacchetti S, Perpoint B, Zidani R, et al. Phase III multicenter randomized trial of oxaliplatin added to chronomodulated ﬂuorouracil-leucovorin as ﬁrst-line treatment of metastatic colorectal cancer[J]. J Clin Oncol, 2000, 18(1): 136-147.
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6.	Diaz-Rubio E, Tabernero J, Gomez-Espana A， et al. Phase Ⅲ study of capecitabine plus oxaliplatin compared with continuous-infusion ﬂuorouracil plus oxaliplatin as ﬁrst-line therapy in metastatic colorectal cancer: ﬁnal report of the Spanish Cooperative Group for the Treatment of Digestive Tumors Trial[J]. J Clin Oncol, 2007, 25(27): 4224-4230.
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8.	Shirao K, Ohtsu A, Takada H, et al. PhaseⅡ study of oral S-1 for treatment of metastatic colorectal carcinoma[J]. Cancer, 2004, 100(11): 2355-2361.
9.	Malik ST, Talbot D, Clarke PI, et al. PhaseⅡ trial of UFT in advanced colorectal and gastric cancer[J]. Br J Cancer, 1990, 62(6): 1023-1025.
10.	Mathé G, Kidani Y, Segiguchi M, et al. Oxalato-platinum or 1-OHP, a third-generation platinum complex: an experimental and clinical appraisal and preliminary comparison with cis-platinum and carboplatinum[J]. Biomed Pharmacother, 1989, 43(4): 237-250.
11.	王艳荣，张芳.运用奥沙利铂联合化疗治疗大肠癌的观察及护理[J].现代护理，2001，7(10): 39.
12.	罗丽莹，吕韶敏，刘文超.奥沙利铂联合氟尿嘧啶四氢叶酸治疗胃肠道恶性肿瘤43例[J].第四军医大学学报，2002，23(5): 475.
13.	万以叶.草酸铂联合氟尿嘧啶、甲酰四氢叶酸治疗晚期大肠癌的疗效观察[J].中国癌症杂志，2001，11(6):566.
14.	Fischel JL, Formento P, Ciccolini J, et al. Impact of the oxaliplatin-5 fluorouracil-folinic acid combination on respective intracellular determinants of drug activity[J]. Br J Cancer, 2002, 86(7): 1162-1168.
15.	Boisdron-Celle M，Craipeau C，Brienza S，et al，Influence of oxaliplatin on 5-fluorouracil plasma clearance and clinical consequences[J]. Cancer Chemother Pharmacol，2002，49(3): 235-243.
16.	Li J, Yin J, Zhu X, et al. PhaseⅠ dose-escalating study of S-1 in combination with oxaliplatin for patients with advanced and/or metastatic colorectal cancer[J]. Anticancer Drugs, 2008, 19(7): 745-748.
17.	Kim HS, Park MJ, Uhm JE, et al. A phaseⅠ trial of S-1 with oxaliplatin in patients with relapsed and metastatic colorectal cancer[J]. Int J Colorectal Dis, 2009, 24(11): 1311-1316.
18.	Hong YS, Lee JL, Park JH, et al. PhaseⅠ study of preoperative chemoradiation with S-1 and oxaliplatin in patients with locally advanced resectable rectal cancer[J]. Int J Radiat Oncol Biol Phys, 2011, 79(3): 684-689.
19.	Zang DY, Lee BH, Park HC, et al. PhaseⅡ study with oxaliplatin and S-1 for patients with metastatic colorectal cancer[J]. Ann Oncol, 2009, 20(5): 892-896.
20.	Doi Y, Okada T, Matsumoto H, et al. Combination therapy of metronomic S-1 dosing with oxaliplatin-containing polyethylene glycol-coated liposome improves antitumor activity in a murine colorectal tumor model[J]. Cancer Sci, 2010, 101(11): 2470-2475.
21.	Hong J, Han SW, Ham HS, et al. PhaseⅡ study of biweekly S-1 and oxaliplatin combination chemotherapy in metastatic colorectal cancer and pharmacogenetic analysis[J]. Cancer Chemother Pharmacol, 2011, 67(6): 1323-1331.

1. 　de Gramont A, Figer A, Seymour M, et al. Leucovorin and ﬂuorouracil with or without oxaliplatin as ﬁrst-line treatment in advanced colorectal cancer[J]. J Clin Oncol, 2000, 18(16): 2938-2947.
2. 　Giacchetti S, Perpoint B, Zidani R, et al. Phase III multicenter randomized trial of oxaliplatin added to chronomodulated ﬂuorouracil-leucovorin as ﬁrst-line treatment of metastatic colorectal cancer[J]. J Clin Oncol, 2000, 18(1): 136-147.
3. 　Douillard JY, Cunningham D, Roth AD, et al. Irinotecan combined with ﬂuorouracil compared with ﬂuorouracil alone as ﬁrst-line treatment for metastatic colorectal cancer: a multicentre randomised trial[J]. Lancet, 2000, 355(9209): 1041-1047.
4. 　Meyerhardt JA, Mayer RJ. Systemic therapy for colorectal cancer[J]. N Engl J Med, 2005, 352: 476-487.
5. 　Cassidy J, Clarke S, Díaz-Rubio E, et al. Randomized phase Ⅲ study of capecitabine plus oxaliplatin compared with ﬂuorouracil/folinic acid plus oxaliplatin as ﬁrst-line therapy for metastatic colorectal cancer[J]. J Clin Oncol， 2008，26(12): 2006-2012.
6. 　Diaz-Rubio E, Tabernero J, Gomez-Espana A， et al. Phase Ⅲ study of capecitabine plus oxaliplatin compared with continuous-infusion ﬂuorouracil plus oxaliplatin as ﬁrst-line therapy in metastatic colorectal cancer: ﬁnal report of the Spanish Cooperative Group for the Treatment of Digestive Tumors Trial[J]. J Clin Oncol, 2007, 25(27): 4224-4230.
7. 　Ohtsu A, Baba H, Sakata Y, et al. PhaseⅡ study of S-1, a novel oral ﬂuoropyrimidine derivative, in patients with metastatic colorectal carcinoma.[J]. Br J Cancer， 2000，83(2): 141-145.
8. 　Shirao K, Ohtsu A, Takada H, et al. PhaseⅡ study of oral S-1 for treatment of metastatic colorectal carcinoma[J]. Cancer, 2004, 100(11): 2355-2361.
9. 　Malik ST, Talbot D, Clarke PI, et al. PhaseⅡ trial of UFT in advanced colorectal and gastric cancer[J]. Br J Cancer, 1990, 62(6): 1023-1025.
10. 　Mathé G, Kidani Y, Segiguchi M, et al. Oxalato-platinum or 1-OHP, a third-generation platinum complex: an experimental and clinical appraisal and preliminary comparison with cis-platinum and carboplatinum[J]. Biomed Pharmacother, 1989, 43(4): 237-250.
11. 　王艳荣，张芳.运用奥沙利铂联合化疗治疗大肠癌的观察及护理[J].现代护理，2001，7(10): 39.
12. 　罗丽莹，吕韶敏，刘文超.奥沙利铂联合氟尿嘧啶四氢叶酸治疗胃肠道恶性肿瘤43例[J].第四军医大学学报，2002，23(5): 475.
13. 　万以叶.草酸铂联合氟尿嘧啶、甲酰四氢叶酸治疗晚期大肠癌的疗效观察[J].中国癌症杂志，2001，11(6):566.
14. 　Fischel JL, Formento P, Ciccolini J, et al. Impact of the oxaliplatin-5 fluorouracil-folinic acid combination on respective intracellular determinants of drug activity[J]. Br J Cancer, 2002, 86(7): 1162-1168.
15. 　Boisdron-Celle M，Craipeau C，Brienza S，et al，Influence of oxaliplatin on 5-fluorouracil plasma clearance and clinical consequences[J]. Cancer Chemother Pharmacol，2002，49(3): 235-243.
16. 　Li J, Yin J, Zhu X, et al. PhaseⅠ dose-escalating study of S-1 in combination with oxaliplatin for patients with advanced and/or metastatic colorectal cancer[J]. Anticancer Drugs, 2008, 19(7): 745-748.
17. 　Kim HS, Park MJ, Uhm JE, et al. A phaseⅠ trial of S-1 with oxaliplatin in patients with relapsed and metastatic colorectal cancer[J]. Int J Colorectal Dis, 2009, 24(11): 1311-1316.
18. 　Hong YS, Lee JL, Park JH, et al. PhaseⅠ study of preoperative chemoradiation with S-1 and oxaliplatin in patients with locally advanced resectable rectal cancer[J]. Int J Radiat Oncol Biol Phys, 2011, 79(3): 684-689.
19. 　Zang DY, Lee BH, Park HC, et al. PhaseⅡ study with oxaliplatin and S-1 for patients with metastatic colorectal cancer[J]. Ann Oncol, 2009, 20(5): 892-896.
20. 　Doi Y, Okada T, Matsumoto H, et al. Combination therapy of metronomic S-1 dosing with oxaliplatin-containing polyethylene glycol-coated liposome improves antitumor activity in a murine colorectal tumor model[J]. Cancer Sci, 2010, 101(11): 2470-2475.
21. 　Hong J, Han SW, Ham HS, et al. PhaseⅡ study of biweekly S-1 and oxaliplatin combination chemotherapy in metastatic colorectal cancer and pharmacogenetic analysis[J]. Cancer Chemother Pharmacol, 2011, 67(6): 1323-1331.

West China Medical Journal

Clinical Observation of Treatment for Advanced Colorectal Cancer with S-1 Plus Oxaliplatin

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