摘要
目的比较卡培他滨(希罗达)联合奥沙利铂(XELOX)方案与亚叶酸钙、氟尿嘧啶(5-Fu)联合奥沙利铂(FOLFOX4)方案一线治疗晚期转移性结直肠癌的疗效和不良反应。方法将56例晚期结直肠癌患者随机分为两组,XELOX方案组(28例):卡培他滨(capecitabine,Xeloda)1000mg/m^2,Bid,口服,d1-14;奥沙利铂(oxaliplatin)130mg/m^2,静脉滴注,持续2h,d1;21 d为1周期。FOLFOX4方案组(28例):奥沙利铂85 mg/m^2,静脉点滴2 h,d1;醛氢叶酸200 mg/m^2,静脉点滴2 h,d1、2;氟尿嘧啶400 mg/m^2,莫非氏管静脉推注d1、2;氟尿嘧啶600 mg/m^2,静脉持续滴注(化疗泵),持续22 h,d1、2,14 d为1周期。结果 XELOX组总有效率(RR)50.0%,中位肿瘤进展时间(TTP)7.0个月;FOLFOX4组RR为46.4%,TTP为6.8个月;两组比较各项指标差异无显著性(P〉0.05)。不良反应中XELOX组手足综合征发生率高于FOLFOX4组,Ⅲ、Ⅳ度中性粒细胞减少发生率低于FOLFOX4组。结论 XELOX方案一线治疗晚期结直肠癌有确切疗效,不良反应可耐受,与FOL-FOX4方案相当,但XELOX方案用药更为方便,安全性更好。
Objective To compare the clinical efficacy and toxicity of XELOX regimen and FOLFOX4 regimen as the first-line chemotherapy of metastatic colorectal cancer.Methods Fifty-six metastatic colorectal cancer patients were randomly assigned to two groups:XELOX and FOLFOX4 groups.In XELOX group,the patients were treated with capecitabine 1000 mg/m^2 orally twice everyday from day 1 to day 14,oxaliplatin 130 mg/m^2 iv gtt for 2 hours on day 1,repeated every 3 weeks.In FOLFOX4 group,oxaliplatin 85 mg/m^2 iv gtt for 2 hours on day 1,calcium folinate 200 mg/m^2 iv gtt on d1-2 followed by 5-Fu 400 mg/m^2 iv bolus on day 1-2 and 600 mg/m^2 iv gtt for 22 hours continuously on day1-2,repeated every 2 weeks.Results In XELOX group,the response rate(RR)was 50.0%,the median time to progression(TTP)was 7.0 months.In FOLFOX4 group,RR was 46.4%,median TTP was 6.8 months(P0.05).There were more patients who developed hand-foot syndrome and less patients who developed grade Ⅲ,Ⅳ neutropenia in XELOX group compared with FOLFOX4 group.Conclusion XELOX regimen as first-line chemotherapy for metastatic colorectal cancer is as effective and tolerable as FOLFOX4 regimen,but XELOX regimen is more convenient and safe.
出处
《中国肿瘤临床与康复》
2011年第1期53-55,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
结直肠肿瘤
卡培他滨
奥沙利铂
Colorectal neoplasms
Capecitabine
Oxaliplatin