FOLFOX和FOLFOXIRI方案在Ⅲ期结肠癌辅助化疗中的疗效

Comparison of FOLFOX and FOLFOXIRI regime in adjuvant chemotherapy of stage Ⅲ colorectal cancer

目的:比较FOLFOX和FOLFOXIRI两种辅助化疗方案在Ⅲ期结肠癌患者中的疗效及安全性。方法:回顾性分析2007年4月至2011年7月结肠癌根治术后接受FOLFOX或FOLFOXIRI两种化疗方案的58例Ⅲ期结肠癌患者,观察不良反应发生情况,比较两种方案患者的3年无病生存期和总生存期,采用KaplanMerier进行生存分析。结果:对接受FOLFOX或FOLFOXIRI两种不同辅助化疗方案的58例患者,FOLFOXIRI组在白细胞减少及腹泻方面有更高的不良事件发生率,其余不良反应与FOLFOX组相似。两组3年无病生存率分别为50%、46.7%,3年总生存率分别为32.1%和30%,P值分别为0.64和0.91,两组间差异无统计学差异。但在亚组分析中,FOLFOXIRI组的Ⅲc期患者3年无病生存期明显提高,P值为0.03,存在差异。结论:FOLFOX和FOLFIXIRI两种辅助化疗方案治疗结肠癌总体安全性较好,两组之间生存差异无显著性,但在Ⅲc期亚组分析DFS中,后者更具生存优势。

Objective： To compare the efficacy and safety of FOLFOX and FOLFOXIRI in stage Ⅲ colonic cancer.Methods： The clinical and pathological data of stage Ⅲ colonic cancer patients with radical resection who received FOLFOX or FOLFOXIRI regimes were retrospectively evaluated. Results： For 58 cases randomized to receive the FOLFOX or FLOFOXIRI two different regimes. FOLFOXIRI group had a higher incidence of leucopenia and diarrhea.Other adverse effects of FOLFOXIRI regime were similar to FOLFOX regime. The three-year DFS rates were 50%and 46. 7% and the three-year OS rates were 32. 1% and 30% in two groups respectively（ P = 0. 64,P = 0. 91）.There was no significant difference between the two groups. But there was a higher three-year DFS rates in advanced analysis of stage Ⅲcpatients with a significant difference in statistics in FOLFOXIRI subgroup（ P = 0. 03）. Conclusion： Two adjuvant chemotherapy regimens can be both safety used for treating colonic cancer. There was no significant survival difference between two groups. In advanced analysis of DFS in stage Ⅲcsubgroup,FOLFOXIRI had a better trend of survival advantage.