XELOX方案治疗晚期结直肠癌临床观察

Clinical observation of treatment of advanced colorectal cancer with XELOX regimen

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、氟尿嘧啶（5-Fu）联合奥沙利铂（FOLFOX4）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56例晚期结直肠癌患者随机分为两组,XELOX方案组（28例）：卡培他滨（capecitabine,Xeloda）1000mg/m^2,Bid,口服,d1-14;奥沙利铂（oxaliplatin）130mg/m^2,静脉滴注,持续2h,d1;21 d为1周期。FOLFOX4方案组（28例）：奥沙利铂85 mg/m^2,静脉点滴2 h,d1;醛氢叶酸200 mg/m^2,静脉点滴2 h,d1、2;氟尿嘧啶400 mg/m^2,莫非氏管静脉推注d1、2;氟尿嘧啶600 mg/m^2,静脉持续滴注（化疗泵）,持续22 h,d1、2,14 d为1周期。结果 XELOX组总有效率（RR）50.0%,中位肿瘤进展时间（TTP）7.0个月;FOLFOX4组RR为46.4%,TTP为6.8个月;两组比较各项指标差异无显著性（P〉0.05）。不良反应中XELOX组手足综合征发生率高于FOLFOX4组,Ⅲ、Ⅳ度中性粒细胞减少发生率低于FOLFOX4组。结论 XELOX方案一线治疗晚期结直肠癌有确切疗效,不良反应可耐受,与FOL-FOX4方案相当,但XELOX方案用药更为方便,安全性更好。

Objective To compare the clinical efficacy and toxicity of XELOX regimen and FOLFOX4 regimen as the first-line chemotherapy of metastatic colorectal cancer.Methods Fifty-six metastatic colorectal cancer patients were randomly assigned to two groups：XELOX and FOLFOX4 groups.In XELOX group,the patients were treated with capecitabine 1000 mg/m^2 orally twice everyday from day 1 to day 14,oxaliplatin 130 mg/m^2 iv gtt for 2 hours on day 1,repeated every 3 weeks.In FOLFOX4 group,oxaliplatin 85 mg/m^2 iv gtt for 2 hours on day 1,calcium folinate 200 mg/m^2 iv gtt on d1-2 followed by 5-Fu 400 mg/m^2 iv bolus on day 1-2 and 600 mg/m^2 iv gtt for 22 hours continuously on day1-2,repeated every 2 weeks.Results In XELOX group,the response rate（RR）was 50.0%,the median time to progression（TTP）was 7.0 months.In FOLFOX4 group,RR was 46.4%,median TTP was 6.8 months（P0.05）.There were more patients who developed hand-foot syndrome and less patients who developed grade Ⅲ,Ⅳ neutropenia in XELOX group compared with FOLFOX4 group.Conclusion XELOX regimen as first-line chemotherapy for metastatic colorectal cancer is as effective and tolerable as FOLFOX4 regimen,but XELOX regimen is more convenient and safe.