XELOX与FOLFOX6方案一线治疗晚期结直肠癌的近期疗效及不良反应比较

Efficacy and side effect of XELOX and FOLFOX6 as first-line chemotherapy on metastatic colorectal cancer

目的:比较卡培他滨(希罗达)联合奥沙利铂(XELOX)方案与亚叶酸钙、5-氟尿嘧啶(5-FU)联合奥沙利铂(FOLFOX6)方案一线治疗晚期转移性结、直肠癌的疗效和不良反应。方法:将62例晚期结、直肠癌患者随机分为两组,XELOX方案组(n=31):卡培他滨(capecitabine,Xeloda)1000mg/m2,2次/d,口服,第1天至第14天;奥沙利铂(oxaliplatin)130mg/m2,静脉滴注,持续3h,第1天;21天为1周期。FOLFOX6方案组(n=31):亚叶酸钙(CF)200mg/m2,静脉滴注,第1天,5-FU前;5-FU400mg/m2,静脉推注,第1天,2400mg/m2,静脉持续滴注46h;奥沙利铂100mg/m2,静脉滴注,持续3h,第1天;14天为1周期。结果:XELOX组缓解率(RR)为48.4%,中位肿瘤进展时间(TTP)6.8个月;FOLFOX6组RR为51.6%,TTP为7.1个月;两组比较各项指标差异无统计学意义(P>0.05)。不良反应中XELOX组手足综合征发生率高于FOLFOX组,Ⅲ、Ⅳ度中性粒细胞减少发生率低于FOLFOX6组。结论:XELOX方案一线治疗晚期结、直肠癌有确切疗效,不良反应能耐受,与FOLFOX6方案相当,但XELOX方案用药更为方便,安全性更好。

Objective：To compare the clinical effects and toxicities of XELOX regimen and FOLFOX6 rigimen as the first - line chemotherapy on metastatic colorectal cancer. Methods ： Sixty two metastatic colorectal cancer patients were randomly assigned to two groups , XELOX and FOLFOX6 groups. In XELOX group, patients were treated with capecitabine 1000mg/m^2 oral twice everyday from day 1 to day 14;oxaliplatin 130mg/m^2 iv infusion for 3 hours on day 1, repeated every 3 weeks. In FOLFOX6 group, CF 200mg/m^2 iv infusion dl followed by 5 - FU 400mg/m^2 iv bolus on day 1 and 2400mg/m^2 iv infusion continuously for 46 hours;oxaliplatin 100mg/m^2 iv infusion for 3 hours on day 1 ,repeated every 2 weeks. Results： In XELOX group,the response rate （RR） was 48.4% ,the median time to progression （TIP） was 6.8 months. In FOLFOX6 group, RR was 51.6%, median TIP was 7.1 months （P 〉 0. 05 ）. There were more patients who developed hand - foot syndrome and less of grade Ⅲ, Ⅳ neutropenia in XELOX group. Conclusion： XELOX rigimen as first - line chemotherapy for metastatic colorectal cancer is as effective and tolerable as FOLFOX6 rigimen. But XELOX rigimen is more convenient and safe.