替吉奥及卡培他滨联合奥沙利铂一线治疗晚期大肠癌的近期疗效比较

Clinical study of oxaliplatin plus TS-1 or capecitabine in the treatment of advanced colon cancer

目的比较替吉奥联合奥沙利铂（SOX方案）与卡培他滨联合奥沙利铂（XELOX方案）一线治疗晚期大肠癌的有效性和安全性.方法 53例晚期大肠癌患者随机分为两组,SOX方案组26例,具体为：L-OHP 130 mg/m2静滴3h,d1；S-1 40 mg/m2分早晚2次餐后服用,d1～d14, 3周为1周期；XELOX方案组27例,具体为：L-OHP 130 mg/m2静滴3h,d1；卡培他滨1000 mg/m2分早晚2次餐后服用,d1～d14,3周为1周期.2个周期评价疗效及毒性.结果 53例均可评价疗效, SOX方案组、XELOX方案组两组的有效率分别为46.7％和48.2％,疾病控制率为80.0％和75.9％,中位疾病进展时间为8.9个月和9.3个月，上述两组差异均无统计学意义（P＞0.05）.两组毒副反应主要包括血液学毒性、肝肾功能异常、恶心呕吐、腹泻、末梢神经毒性和手足综合征等,以1～2级为主,均可耐受，其中替吉奥组的恶心呕吐发生率略高于卡培他滨组，但卡培他滨组的腹泻、手足综合征发生率明显高于替吉奥组。结论 卡培他滨联合L-OHP与S-1联合L-OHP治疗晚期大肠癌的疗效相当,不良反应均可耐受。

Objective To investigate the Clinical efficacy and safety of the two chemotherapy regimen based on Oxaliplatin combined with capecitabine or TS-1 in the treatment of advanced colon cancer. Methods 53 advanced colon cancer patients were involved in this study. 26 patients were given the regimen of SOX： Oxaliplatin（130 mg/m2） was administered intravenously in three hours on day 1, while S-1（40 mg/m2） was administered orally twice daily for 14 consecutive days. 27 patients were given the regimen of XELOX： Oxaliplatin Capecitabine was administered intravenously in three hours on day 1, while Capecitabine（1000mg/m2） was administered orally twice daily for 14 consecutive days.The regimens were repeated every 3 weeks. The efficacy and toxicy were evaluated after 2 cycles. Results All the 53 patients were eligille for enrollment and the patients were appreciable for efficacy and toxicy. The objective response rate（ORR） was 46.7% and 48.2% in the SOX regimen and XELOX regimen respectly. The disease control rate （DCR） was 80.0% and 75.9%. The median time to progression （TTP） was 8.9 months and 9.3 months. There were no significent difference. The objective side effects associated with the regimens were bone marrow suppressive, digestive system reaction （diarrhea or vomiting）, peripheral neuropathy and hand-foot syndrome,and mostly graded 1 or 2. Conclusion There were no significent difference in the efficacy in the two chemotherapy regimens. And the side toxicities were all well tolerable.