XELOX方案和mFOLFOX6方案治疗转移性结直肠癌的疗效与毒副反应观察

The Comparison of the curative effect and adverse reaction of XELOX regimen and mFOLFOX6 regimen in treatment of metastatic colorectal cancer

目的观察XELOX(卡培他滨+奥沙利铂)方案和mFOIFOX6(奥沙利铂+5-Fu+亚叶酸钙)方案治疗转移性结直肠癌的近期疗效及毒副反应。方法 64例转移性结直肠癌患者随机分为XELOX组30例和mFOLFOX6组34例。XELOX组给予奥沙利铂130 mg/m^2,静脉滴注2 h,第1天;卡培他滨1000 mg/m^2,分早晚2次口服,连用14 d;3周为1周期。mFOLFOX6组给予奥沙利铂85 mg/m^2,静脉滴注2 h,第1天;亚叶酸钙400 mg/m^2,静脉滴注2 h后予5-氟尿嘧啶400 mg/m^2,静脉推注,后续2 400 mg/m^2,持续静滴46 h,每2周重复,4周为1周期。患者均接受至少2周期的化疗。依据RESIST评价近期疗效,依据WHO标准评价毒副反应。结果 XEL0X组与mFOLFOX 6组有效率分别为43.3%和41.2%,两组中位疾病进展时间分别为5.5个月与6.0个月,差异无统计学意义(P>0.05);XELOX组恶心呕吐发生率显著低于mFOIFOX6组(P<0.05);XELOX组手足综合征发生率明显高于mF0LF0X 6组(P<0.05),但程度较轻,主要为Ⅰ~Ⅱ度。其他的毒副反应两组无明显差异(P>0.05)。结论 XELOX方案与mFOLFOX6方案治疗转移性结直肠癌疗效确切且相似,毒副反应可耐受,XELOX方案更安全。

Objective To compare the curative effect and adverse reaction of capecitabine, oxaliplatin （XELOX） and 5-fluorouracil（5-FU）, leucovorin（LV）, oxaliplatin （mFOLFOX6） in treatment of meta-static colorectal cancer. Methods 64 patients with metastatic colorectal cancer were enrolled into this study, 30 patients and 34 patients were randomly divided into XELOX group and mFOLFOX6 group respectively. XELOX group received oxaliplatin at the dose of 130mg/m2 by dropping on day 1 and oral administration of capecitabine at 1 000mg/m2 twice a day on day 1-14. mFOLFOX6 group was treated with oxaliplatin 85mg/m2 by dropping in 2-hour on day 1;LV 400 mg/m2 by dropping in 2-hour followed by 5-Fu 400 mg/m2 by inject and 5-Fu 2 400 mg/m2 by continue dropping for 46-hour. XELOX regimen was repeated every three weeks for one cycle;mFOLFOX6 regimen was repeated every two weeks and four weeks for one cycle. All patients received two cycles of chemotherapy at least. The curative effect was evaluated according to RESIST standards. The adverse reaction was evaluated according to WHO standards. Results The overall response rates of XELOX group and mFOLFOX6 group were 43. 3% and 41. 2% individually. The median time to progression （mTTP） were 5. 5 months in XELOX group and 6. 0 months in mFOLFOX6 group respectively. There was no statistical significance between the two groups （P〉0. 05）. In terms of adverse reactions,the incidence of grade Ⅰ to II side effect of digestive tract （ nausea and vomiting ） was significantly lower in＆amp;nbsp;XELOX group than that in mFOLFOX6 group （P〈0. 05） ,but the incidence of hand and foot syndrome in XELOX group was more significantly than that in mFOLFOX6 group （ P〈0 . 05 ） , but kept at light extent which mainly be gradedⅠtoII. The incidence of other adverse reactions has no statistical significance be-tween the two groups （P〉0. 05）. Conclusion XELOX regimen and mFOLFOX6 regimen are effective, two regimens have very similar curative effect with tolerable adverse reaction in treatment for metastatic colorectal cancer, but XELOX regimen may be safer than mFOLFOX6 regimen.