卡培他滨联合奥沙利铂治疗晚期转移性结、直肠癌疗效分析  

Analysis of effects of the combination of capecitabine and oxaliplatin as first-line chemotherapy on metastatic colorectal cancer

作　　者：张迦维[1] 缪建华[1] 赵帆[1] 陈暑波[1] 过雪丹[1] 

机构地区：[1]无锡市第二人民医院肿瘤科,江苏无锡214000

出　　处：《现代医学》2008年第1期37-39,共3页Modern Medical Journal

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、5-氟脲嘧啶（5-FU）联合奥沙利铂（FOLFOX6）方案一线治疗晚期转移性结、直肠癌的疗效和小良反应。方法 将98例晚期结、直肠癌患者随机分为两组。XELOX方案组（n=31）：卡培他滨1000mg·m^^2，2次·d^-1，口服，第1天至第14天；奥沙利铂130mg·m^-2，静脉滴注，持续2h，第1天；21d为一周期。FOLFOX6方案组（n=67）：亚叶酸钙（CF）300mg·m^-2，静脉滴注，第1天；5-FU 400mg·m^-2，静脉推注，第1天，2400～3000mg·m^-2，静脉持续滴沣46h；奥沙利铂100mg·m^-2，静脉滴注，持续2h，第1天；14天为一周期。结果随访3～20个月，XELOX组缓解率（RR）为48．4％，中他肿瘤进展时间7．1个月，中位生存时间13．7个月，1年生存率61．3％；FOLFOX6组RR为47．8％，中位肿瘤进展时间7．5个月，中位生存时间14．1个月，1年生存率68．7％；两组比较各项指标差异无统计学意义（P〉0．05）。不良反应中XELOX组Ⅲ、Ⅳ度手足综合征发生率高于FOLFOX6组，Ⅲ、Ⅳ度白细胞减少发生率低于FOLFOX6组。结论XELOX方案一线治疗晚期结、直肠癌有确切疗效，不良反应能耐受，与FOLFOX6方案相当，有望取代FOLFOX6方案成为标准治疗方案或备选方案。Objective To compare the effects and side effects of XELOX regimen and FOLFOX6 regimen as the first-line chemotherapy on the metastatic colorectal cancer. Methods：Ninety-eight metastatic colorectal cancer patients were randomly assigned to two groups, XELOX and FOLFOX6 groups. In XELOX group, patients were given xeloda 1 000 mg·m^-2 Bid, per os, from day 1 to day 14,oxaliplatin 130mg·m^-2,ivgtt for 2 hours on day 1. The treatment cycle was every 21 days. In FOLFOX6 group, patients were given calcium foli- nate （CF） 300mg·m^-2, ivgtt, day I ,5-FU 400 mg·m^-2, ivgtt, day 1, 2 400 - 3 000mg·m^-2,ivgtt continuously for 46 hours, oxaliplatin 100mg·m^-2, ivgtt for 2 hours on day 1. The treatment cycle was every 14 days. Results The follow-up periods were 3-20 months. In XELOX group, the response rate （RR） was 48.4% , the median time of tumor progression was 7.1 months, the median survival was 13.7 months, and the one-year-survival was 61.3%. In FOLFOX6 group, the RR was 47.8% , the median time of tumor progression was 7.5 months, the median survival was 14.1 months, and the one-year-survival was 68.7% （P 〉 0. 05 ）. There were more patients who developed grade Ⅲ , Ⅳ hand-foot syndrome and less of grade Ⅲ , Ⅳ neurotoxieity and grade Ⅲ , Ⅳ WBC decrease occurring in XELOX group. Conclusion First-line chemotherapy of XELOX for metastatic eoloreetal cancer is as effective and tolerable as FOLFOX6, and may be the standard regimen instead of FOLFOX6.

关 键 词：结 直肠癌 卡培他滨 奥沙利铂 

分 类 号：R735.3[医药卫生—肿瘤]