草酸铂联合氟尿嘧啶/亚叶酸钙与草酸铂联合卡培他滨治疗晚期结直肠癌的疗效  

The Clinical efficacy of Fluorouracil/leucovorin and Oxaliplatin plus Capecitabine Chemotherapy on advanced Colorectal Cancer

作　　者：张希[1] 贾勋超 

机构地区：[1]雅安市人民医院肿瘤科,四川雅安625000

出　　处：《华西医学》2013年第3期373-376,共4页West China Medical Journal

摘　　要：目的比较草酸铂联合氟尿嘧啶/亚叶酸钙(FOLFOX4)与草酸铂联合卡培他滨(XELOX)治疗晚期结直肠癌的临床疗效。方法将2007年1月-2011年12月收治的58例转移或复发晚期结直肠癌患者按照化学疗法(化疗)方案的不同分为两组,其中FOLFOX4组28例(男性患者占57.1%,平均年龄56.3岁),XELOX组30例(男性患者占63.3%,平均年龄57.8岁)。所有患者疗程不少于2个化疗周期,评价指标为病情缓解率和化疗药物的毒副作用。结果 FOLFOX4组完全缓解率(CR)和部分缓解率(PR)分别为10.7%(3/28)和32.1%(9/28),总有效率为42.8%(12/28);XELOX组CR和PR率分别为13.3%(4/30)和30.0%(9/30),总有效率为43.3%(13/30),两组总有效率差异无统计学意义(P=0.971)。XELOX组有10.0%(3/30)和16.7%(5/30)的患者分别出现中性粒细胞降低和神经毒性,但均显著低于FOLFOX4组[39.3%(11/28)、43.3%(13/30)](P=0.009,0.014)。XELOX组手足综合症发生率明显高于FOLFOX4组[40.0%(12/30)、14.5(4/28),P=0.029),但程度较轻,主要为Ⅰ～Ⅱ度。结论 XELOX与FOLFOX4化疗方案治疗晚期结直肠癌患者的疗效相似,但XELOX化疗方案毒副反应相对较小。Objective To investigate the curative efficacy of oxaliplatin plus fluorouracil/leucovorin（FOLFOX4） and oxaliplatin plus capecitabine（XELOX） on advanced colorectal cancer.Methods Between January 2007 and December 2011,48 patients with advanced colorectal cancer were included and received two different chemotherapy regimens： 28 patients in FOLFOX4 group and 30 patients in XELOX group.All patients completed at least two cycles of chemotherapy.After the treatment,remission rate and toxicity of chemotherapy were evaluated.Results The rate of complete remission（CR） and partial remission（PR） was 10.7%（3/28） and 32.1%（9/28） in the FOLFOX4 group,and the overall efficacy rate was 42.8%（12/28）;while the rate of CR and PR was 13.3%（4/30） and 30.0%（9/30） in XELOX group,and the corresponding overall efficacy rate was 43.3%（13/30）.The difference in overall response was not statistically significant between the two groups（P=0.971）.There was 10.0%（3/30） and 16.7%（5/30） patients in XELOX group reported neutropenia and neurotoxicity,which were significantly lower than that in FOLFOX4 group [39.3%（11/28） and 43.3%（13/30）]（P=0.009,0.014）.The occurrence rate of hand-foot syndrome in XELOX group was higher than that in FOLFOX4 group [40.0%（12/30）,14.5（4/28）;P=0.029],but the degree of the syndrome in XELOX group was slight,and the majority of them were grade Ⅰ to Ⅱ.Conclusions The strategies of XELOX and FOLFOX4 chemotherapy have similar curative efficacy on advanced colorectal cancer,but chemotherapy associated toxicity is significantly lower in the former one.

关 键 词：结直肠癌 化学疗法 草酸铂联合卡培他滨方案 草酸铂联合氟尿嘧啶 亚叶酸钙方案 疗效 

分 类 号：R735.3[医药卫生—肿瘤]