奥沙利铂联合氟尿嘧啶/亚叶酸钙一线治疗转移性大肠癌2周方案与3周方案的对比研究

Comparison of 2-week regimen and 3-week regimen based on oxaliplatin plus 5-fluorouracil and Calcium folinate as the first-line in the treatment of metastatic colorectal cancer

目的：比较奥沙利铂（L-OHP）联合5-氟尿嘧啶/亚叶酸钙（5-FU/CF）的2周方案与3周方案一线治疗转移性结直肠癌的临床疗效及不良反应。方法：66例转移性结直肠癌患者随机接受治疗。A组,予L-OHP85mg/m^2,第1天,静脉滴注2h,同时或之后予CF200mg/m^2,静脉滴注2h,续5-FU400mg/m^2,静脉推注,600mg/m^2持续静脉滴注22h,次日重复CF与5-FU。每2周重复1次,每2次计为1周期。B组,予L-OHP130mg/m^2,第1天,静脉滴注2h,CF200mg/m^2,静脉滴注2h,续5-FU375-425mg/m^2静脉滴注4-6h,连用5d,每3周重复1次,每次计为1周期。结果：A、B两组疗效相近,RR分别为42.9%和38.7%（P〉0.05）。两组病例不良反应发生率相似,主要表现为消化道反应、神经系统毒性和脱发。结论：L-OHP联合5-FU/CF的2周方案与3周方案均可作为晚期转移性大肠癌一线治疗的选择之一。

AIM： To compare the efficacy and adverse reaction of oxaliplatin （L-OHP） in first-line chemotherapy of metastatic colorectal cancer（MCC） combined with infusional 5-fluorouracil （5-FU） and Calcium folinate （CF） administered every. 2 weeks （FOL- FOX4 regimen） or every. 3 weeks. METHODS： 66 previously untreated MCC patients were randomized in two chemotherapy regimen group： grouop A, oxaliplatin 85 mg/m^2 on first day, CF 200 mg/m^2 infusion 2 h followed by bolus 5-FU 400 mg/m^2 and a 22 h infusion of 5-FU 600 mg/m^2, repeated for 2 consecutive days every 2 weeks, group B, oxaliplatin 130 mg/m^2 on first day, CF 200 mg/m^2 infusion 2 h followed by a 4 - 6 h infusion of 5-FU 375-425 mg/m^2, repeated for 5 consecutive days every 3 weeks. RESULTS： The two regimens have similar efficacy, the response rate of group A and B was 42.9 % and 38.7 % respectively （ P 〉 0.05）. The adverse reaction rates of the two regimen were no statistical difference. CONCLUSION： The 2- week regimen and the 3-week regimen of L-OHP combined with 5-FU/CF have the same efficacy in MCC patients.