Objective To compare and evaluate the effectiveness and safety of irinotecan (IRI) versus oxaplatin (OXA), in combination with 5-FU/LV for patients with advanced colorectal cancer. Methods The literature search, study selection and assessment, data collection and analysis were undertaken by two reviewers according to the Cochrane Handbook for Systematic Reviews of Interventions. Randomised controlled trials (RCTs) or quasi-RCTs comparing IRI versus OXA, in combination with 5-FU/LV in the treatment of advanced colorectal cancer were collected. Results Seven studies involving 2107 patients were included. The OXA/5-FU/LV regimen was superior or at least equal to the IRI/5-FU/LV regimen in prolonging overall survival and time to progression. The OXA/5-FU/LV regimen showed a higher response rate and was associated with lower toxicities. Conclusion Compared with IRI, OXA is more appropriate for the treatment of advanced colorectal cancer when combined with 5-FU/LV.
Objective To assess clinical efficacy and safety of Oxaliplatin plus Vinorelbine in the treatment of advanced non-small cell lung cancer (NSCLC). Methods We used the methods of Cochrane reviews, electronically searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, 2008), MEDLINE (1966 to April 2008), EMbase (1984 to Dec. 2006), Cancerlit (1996 to Dec. 2005), CBM (1978 to April 2008), CNKI (1994 to April 2008), VIP (1989 to April 2008), and handsearched 15 Chinese medical core journals, to collect randomized controlled trials (RCTs) of Oxaliplatin combined with Vinorelbine in the treatment of advanced NSCLC. RCTs were included according to the inclusion and exclusion criteria, the quality of included trials was evaluated and RevMan 4.2.8 software was used for metaanalyses after the extraction of the data. Results Seventeen RCTs involving 1 399 patients with advanced NSCLC were included. All of them reported the use of a random method, but with no detailed reports of allocation concealment and whether the blind method was used. The results of meta-analyses showed that NO program (vinorelbine + oxaliplatin) and NP program (vinorelbine + cisplatin) were similar in efficient rate (RR=0.97, 95%CI 0.85 to 1.10) and 1-year survival rate (RR=0.82, 95%CI 0.66 to 1.03). Compared with NP program, NO program induced lower III-IV degree of nausea and vomiting response (RR=0.20, 95%CI 0.14 to 0.28), III-IV degree of leukopenia reaction (RR=0.64, 95%CI 0.52 to 0.79), and I-II degree of renal damage RR=0.27, 95%CI 0.11 to 0.60) after chemotherapy. No study reported treatmentrelated death. Conclusion Oxaliplatin and Cisplatin plus Vinorelbine are similar in efficacy in the treatment of advanced NSCLC. Oxaliplatin plus Vinorelbine could be used as a chemotherapy of advanced NSCLC because of its better tolerance and more liability to be accepted by patients. However, highly-potential selection bias and measurement bias would affect the demonstration level of the outcome, so more high-quality double-blind RCTs are needed.
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。
【摘要】 目的 探讨替吉奥胶囊联合奥沙利铂治疗晚期胃癌的近期疗效和毒性反应。 方法 2010年1-7月，16例晚期胃癌患者根据体表面积来确定初始剂量，体表面积lt;1.25 m2，替吉奥胶囊40 mg/次，2次/d；体表面积1.25~1.5 m2，替吉奥胶囊50 mg/次，2次/d；体表面积gt;1.5 m2，替吉奥胶囊60 mg/次，2次/d，早、晚饭后分别口服1次，连续服用28 d，停药14 d。奥沙利铂注射液130 mg/m2加入5%葡萄糖注射液500 mL避光缓慢静gt;2 h，第1、21天重复，连用2周期。按RECIST 1.1标准评价客观疗效和不良反应。 结果 16例患者中PR 9例（56.3%），SD3例（18.8%），PD 4例（25%），总有效率为69.0%。不良反应主要是血液学毒性、胃肠道反应及外周神经毒性，且均在Ⅰ~Ⅱ。 结论 替吉奥胶囊联合奥沙利铂方案治疗晚期胃癌的近期疗效较好，不良反应可以耐受，值得进一步研究应用。【Abstract】 Objective To explore the early efficacy of Oxaliplatin combined with S1 capsule on advanced gastric cancer and observe the toxicity. Methods A total of 16 patients with advanced gastric cancer from January to July 2010 were treated with chemotherapy: oxaliplatin 130 mg/m2 mixed with 5% glucose injection 500 mL in the first day and repeated in the 21st day; Po after breakfast and dinner: S1 capsule with an initial dose according to the body surface area. Body surface lt;1.25 m2, 40 mg once, twice per day; body surface:1.25-1.5 m2,50 mg once, twice per day; body surface gt;1.5 m2, 60 mg once, twice per day. The medication lasted for 28 days, withdrew for 14 days. All of the patients underwent the treatment for two cycles. Efficacy and toxicities were evaluated according to the RECIST 1.1 standard. Results Of the 16 patients, partial remission (PR) was in nine (56.3%), stable disease was in three (18.8%) (SD), and progression disease was in four (PD). The total response rate was 69.0%. The major toxicities included leucopenia, nausea, vomiting and neurosensory abnormity. Conclusion Oxaliplatin combined with S1 capsule is effective on advanced gastric cancer, and the adverse effects are tolerable.
ObjectiveTo evaluate the efficacy and safety of docetaxel (DOC) combined with oxaliplatin (OXA) regimen in the treatment of advanced gastric cancer. MethodsSixty patients with advanced gastric cancer treated in our hospital from January 2008 to January 2011 were randomly divided into two groups. The treatment group (n=30) was given DOC combined with OXA regimen. Patients in this group were treated with DOC 75 mg/m2, ivgtt, d1; OXA 130 mg/m2, ivgtt, d4; with 21 days as a cycle. The control group (n=30) was given DCF regimen. Patients in the control group were treated with DOC 75 mg/m2, ivgtt, d1; cisplatin 75 mg/m2, ivgtt, d1; calcium folinate 200/m2, ivgtt, 2 h, d1-2; fluorouracil 400 mg/m2, bolus 10 minutes, fluorouracil 600 mg/m2 civ 22 h d1-2; also with 21 days as a cycle. All patients received two cycles of chemotherapy at least. The effective rate (complete remission+partial remission), adverse reactions, median survival time and quality of life were analyzed and compared between the two groups. ResultsThe effective rates in the treatment group and the control group were 60.0% and 46.7% respectively, showing a non-significant difference (P>0.05). The appetite increasing rate (70.0% vs 43.3%), the weight gain rate (60.0% vs 33.3%), and the Karnofsky score improvement rate (63.3% vs 30.0%) of the treatment group were significantly higher than those of the control group (P<0.05). The adverse reactions were fewer in the treatment group, and most of them were between grade Ⅰ and Ⅱ. The median time of disease progression (5.8 months vs 5.6 months) and the median survival period (11.8 months vs 9.2 months) of the treatment group were longer than those in the control group. ConclusionDOC combined with OXA regimen is effective in treating advanced gastric cancer. It can significantly improve the quality of life of the patients, and it has fewer adverse reactions. Meanwhile, the median survival period is prolonged. DOC combined with OXA regimen is worth to be applied in clinic.
Objective To evaluate the efficacy and toxicity of the combination of S-1 and oxaliplatin in the first-line chemotherapy of patients with advanced gastric cancer. Methods From March 2012 to April 2013, 57 patients in the First Affiliated Hospital of Guangxi Medical University were enrolled in this study. Oxaliplatin was administered at 130 mg/m2 on day 1, while S-1 was administered orally (< 1.25 m2: 40 mg twice per day; 1.25-1.50 m2: 50 mg twice per day; > 1.50 m2: 60 mg twice per day) for 14 days. The response was evaluated every two chemotherapy cycles. Results The objective response rate was 52.6%, and the disease control rate was 84.2%. The median time to progression was 5.8 months, and the median survival time was 13.5 months. The major grade 3/4 hematological toxic effects were neutropenia (12.3%) and thrombocytope nia (12.3%), and the grade 3/4 non-hematological toxic effects were vomiting, fatigue and sensory neuropathy. The rate of clinical benefit response was 71.9% (41/57). Conclusion The regimen of oxaliplatin and S-1 shows precise efficacy and good tolerance against advanced gastric cancer, and it is worthy of promotion and application in the future.