摘要
目的观察卡培他滨联合奥沙利铂(XELOX)方案与5-氟尿嘧啶/亚叶酸钙联合奥沙利铂(FOLFOX6)方案治疗转移性结直肠癌的疗效及不良反应。方法 58例发生转移的晚期直肠癌患者随机分成XELOX组和FOLFOX6组。其中XELOX组30例,应用奥沙利铂130 mg/m2(第1天)静脉点滴,同时给予卡培他滨1 000 mg/m2(2次/d,第1—14天)口服,3周为1个周期。FOLFOX6组28例,应用奥沙利铂85 mg/m2静脉点滴(第1天),亚叶酸钙400 mg/m2,静滴2 h后予以5-氟尿嘧啶400 mg/m2静滴(第1天),后续1 200 mg/m2持续泵入46~48 h每2周重复,4周为1个周期。2组均治疗2个周期以上。按照WHO标准评价客观疗效和不良反应。结果 58例均可评价疗效,XELOX组有效率47%,中位TTP 7个月,MST 14个月,FOLFOX6组有效率46%,中位TTP 7.2个月,MST 13.8个月。不良反应比较,手足综合征以XELOX组显著(P<0.05),Ⅰ~Ⅱ级恶心呕吐发生率FOLFOX6组略高(P<0.05),余不良反应无明显差别。结论 XELOX方案与FOLFOX6方案在转移性结直肠癌中的治疗中疗效相当,不良反应略有差别,均可作为一线用药。
Objective It is to observe the curative effect and adverse reaction of capecitabine plus oxaliplatin regimen (XELOX) versus 5 - fluorouracil/leucovorin (LV5/FU2) plus oxaliplatin regimen (FOLFOX6) in treatment of metastatic colorectal cancer. Methods Fifty-eight patients with metastatic colorectal cancer were enrolled into this study, 30 patients and 28 patients were randomly divided into XELOX group and FOLFOX6 group respectively. XELOX group was treated with capeeitabine 1 000 mg/(m2 ~ d), po, Bid, dl--14; oxaliplatin 130 mg/(m2 ~ d), ivgtt, dl. FOLFOX6 group was treated with oxaliplatin 85 mg/( m2 ~ d) , ivgtt, dl ; LV 400 mg/m2 ivgtt 2 - hour followed by 5 - Fu 400 mg/m2 bolus and 5 - Fu 1 200 mg/m2 continue infusion for 46 - to 48 - hour. XELOX regimen was repeated every 3 weeks for one cycle; FOLFOX6 regimen was repeated every 2 weeks, 4 weeks for one cycle. All patients received two cycles of chemotherapy at least. The curative effect and adverse reaction were evaluated according to WHO standard. Results All 58 cases were available for objec- tive response. The overall response rate was 46.7% in XELOX group and 46.4% in FOLFOX6. The difference in response rate was not significant between the two groups (P 〉 O. 05). The median time to progression (mTTP) was 7 - month in XE- LOX group and 7.2 - month in FOLFOX6 group. The median survival time (MST) was 14.1 - month in XELOX group and 13.8 - month in FOLFOX6 group. The incidence of grade I to II nausea and vomiting was significantly lower in XELOX group than that in FOLFOX6 group (P 〈 0.05) but hand and foot syndrome in XELOX group were more obvious than that in FOL- FOX6 group ( P 〈 O. 05 ) , but there was no significant difference in the other side effects between two groups ( P 〉 0.05 ). Conclusion Both of the two regimens are feasible, well tolerated and effective in the treatment of metastatic colorectal cancer.
出处
《现代中西医结合杂志》
CAS
2012年第27期2972-2974,共3页
Modern Journal of Integrated Traditional Chinese and Western Medicine