奥沙利铂化学治疗方案在结直肠癌术后辅助治疗的疗效和安全性比较

Efficacy and safety of oxaliplatin chemotherapy programs as adjuvant treatment in colorectal cancer after surgery

目的比较5-氟尿嘧啶＋亚叶酸钙联合奥沙利铂（FOLFOX4／6）方案与卡培他滨联合奥沙利铂（XELOX）方案在进展期结直肠癌术后辅助化学治疗中的疗效和安全性。方法回顾性分析286例进展期结直肠癌患者的术后临床资料，其中204例给予FOLFOX4／6方案术后辅助化学治疗，82例给予XELOX方案术后辅助化学治疗，比较两组患者的3年无病生存率、3年总生存率和n不良反应发生情况。两组计数资料比较采用Z。检验，计量资料比较采用t检验。结果FOLFOX4／6方案组完成12个周期化学治疗的患者153例（75％），XELOX方案组完成8个周期化学治疗的患者66例（80％）。两组患者的3年无病生存率（FOLFOX4／6组临床Ⅱ期患者为87％，Ⅲ期患者为82％；XELOX组Ⅱ期83％，Ⅲ期80Voo）和总生存率（FOLFOX4／6组Ⅱ期92％，Ⅲ期88％；XELOX组Ⅱ期89％，Ⅲ期86％）差异均无统计学意义（P均〉O．05）。FOLFOX4／6和XELOX组患者各种常见不良反应的总发生率差异无统计学意义（P〉0．05），以I和Ⅱ度不良反应多见，Ⅲ和Ⅳ度不良反应非常少见。Ⅲ和Ⅳ度不良反应中，FOLFOX4／6组患者中性粒细胞减少的发生率稍高于XELOX组，而XELOX组患者手足综合征的发生率稍高于FOLFOX4／6组，但差异均无统计学意义9（X2=0．060、0．928，P均〉0．05）。结论FOLFOX4／6与XELOX方案作为进展期结直肠癌术后辅助化学治疗的疗效无明显差异，患者基本可以耐受不良反应，安全性较好。

Objective To compare the efficacy and safety of 5-fluorouracil and calcium folinatc combined with oxaliplatin （FOLFOX） program with capecitabine regimen combined oxaliplatin （XELOX） program as adjuvant chemotherapy in advanced colorectal cancer after surgery. Methods The postoperative clinical data of 286 advanced colorectal cancer patients were retrospectively analyzed. Of which, 204 patients received FOLFOX4/6 adjuvant chemotherapy and 82 patients received XELOX adjuvant chemotherapy. The three-years disease-free survival （DFS） time, three- years overall survival （OS） time and adverse reactions of the two groups were compared. Count data of the two groups＇ were compared by chi-square test, and measurement data were analyzed by t-test. Results In the FOLFOX4/6 group, 153 patients （75%） completed 12 cycles of chemotherapy, and in the XELOX group, 66 patients （80%） finished eight cycles of chemotherapy. There was no statistical difference in three-year DFS incidence （FOLFOX4/6 stage Ⅱ 87%, Ⅲ 82%; XELOX stage U 83%, Ⅲ 80%） and three-year OS incidence （FOLFOX4/6 stage Ⅱ 92%, Ⅲ 880//00; XELOX stage Ⅱ 89%, Ⅲ 86%） between two groups （all P〈0.05）. There was no statistical difference in the incidence of common adverse reactions between FOLFOX4/6 and XELOX group （all P〈0.05）. Adverse reactions of degree I and Ⅱ were more common, while degree Ⅲ and Ⅳ were seldom. Of the adverse reactions of degree Ⅲ and Ⅳ, the incidence of neutropenia in patients of FOLFOX group was a little higher than in those of XELOX group, and the incidence of hand-foot syndrome was a litter higher in XELOX group than in FOLFOX group. However, there was no significant difference （X2 = 0. 060, 0. 928, both P〉0.05）. Conclusion There was no statistical significance between FOLFOX4/6 and XELOX as postoperative auxiliary chemical therapy for advanced colorectal cancer, and both therapies possess good tolerance and safety.