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

Study on the efficacy and adverse reactions of XELOX and FOLFOX6 for first-line treatment in patients with advanced colorectal cancer

目的比较卡培他滨联合奥沙利铂(XELOX)和亚叶酸钙(CF)、5-氟尿嘧啶(5-FU)联合奥沙利铂(FOLFOX6)治疗晚期结直肠癌的近期疗效和不良反应发生率,以指导晚期结直肠癌的治疗。方法将80例患者按照自愿原则分为X组和F组。X组采用XELOX方案治疗,F组采用FOLFOX6方案治疗,统计两组的疗效和不良反应发生情况。结果 X组完全缓解(CR)、部分缓解(PR)、无变化(NC)和进展(PD)分别有7例、13例、14例和6例,治疗有效率(RR)为50.0%,F组治疗有效率为47.5%,两组治疗有效率比较无统计学差异(P>0.05)。在不良反应方面,X组神经毒性、中性粒细胞减少、血小板减少发生率显著低于F组(P<0.05),但是手足综合征发生率明显高于F组(P<0.05)。结论 XELOX和FOLFOX6方案治疗晚期结直肠癌的近期疗效并无显著差异。相比于F方案,X治疗方案用药更为方便,可以显著减少或并不增加除手足综合征外其他不良反应的发生,因此值得在临床中根据患者具体情况考虑优先使用。

Objective To compare the efficacy of capecitabine plus oxaliplatin（ XELOX） and leucovorin（ CF）,5- fluorouracil（ 5-FU） and oxaliplatin（ FOLFOX6） in treatment of patients with advanced colorectal cancer and incidence of adverse reactions in order to guide the treatment in these patients. Methods A total of 80 patients were divided into group X and group F according to the principle of voluntary basis with capecitabine and oxaliplatin therapy or leucovorin,5- fluorouracil and oxaliplatin therapy,and the efficacy and adverse reactions in these 2groups were statistically analyzed. Results CR,PR,NC and PD in patients of group X were 7,13,14 and 6 cases respectively,and the rate of response（ RR） was 50. 0%,and the rate of response（ RR） in group F was 47. 5%,there was no significant difference（ P〉0. 05） in efficacy of treatment. In terms of adverse reactions,neurotoxicity,neutropenia,and thrombocytopenia in group X were significantly lower than those of group F（ P 〈 0. 05）,but the incidence of hand- foot syndrome in group X was significantly higher than that of group F（ P 〈 0. 05）. Conclusion The short term efficacy of capecitabine plus oxaliplatin and leucovorin plus 5- fluorouracil was not significantly different in treatment of patients with advanced colorectal cancer. In comparison with F program,program X is more convenient in application,in addition to the high incidence of hand- foot syndrome,but it can significantly reduce the incidence of adverse reactions,hence it is worthy to be considered in clinical priority according to the specific circumstance of patients.