FOLFOX与XELOX方案治疗晚期结直肠癌毒性表现的系统评价  

Toxicity of FOLFOX versus XELOX as Chemotherapy for Metastatic Colorectal Cancer: a Meta-analysis

作　　者：虞海红 陈建[2] 

机构地区：[1]浙江省杭州市西湖区蒋村文新街道社区卫生服务中心,杭州310030 [2]浙江大学医学院附属第一医院,杭州310012

出　　处：《中国现代应用药学》2013年第11期1245-1249,共5页Chinese Journal of Modern Applied Pharmacy

摘　　要：目的 系统评价氟尿嘧啶/亚叶酸钙联合奥沙利铂（FOLFOX方案）与卡培他滨联合奥沙利铂（XELOX方案）治疗晚期结直肠癌毒性差异,为晚期结直肠癌＂个体化＂药物治疗方案选择提供依据。方法 检索PubMed、Embase、Cochrane、CNKI等数据库和ASCO会议文献,采用系统评价的方法进行系统评价。结果共10个研究4084例患者纳入毒性的系统评价,结果 表明XELOX方案在手足综合症（RR=3.60,95%CI：2.27~5.72,P〈0.0001）、血小板减少（RR=1.83,95%CI：1.36~2.48,P〈0.0001）发生率高于FOLFOX方案,在中性粒细胞减少（RR=0.24,95%CI：0.14~0.41,P〈0.0001）发生率低于FOLFOX方案;恶心、呕吐、腹泻以及神经毒性发生率两方案无统计学差异。结论 在晚期结直肠癌治疗中,FOLFOX方案与XELOX方案在毒性反应方面各有特点,应结合患者具体情况,选择最宜治疗方案。OBJECTIVE To compare toxicities of fluorouracil/folinic acid plus oxaliplatin（FOLFOX） versus capecitabine plus oxaliplatin （XELOX） as chemotherapy for metastatic colorectal cancer. METHODS PubMed database, EMbase database, Cochrane, CNKI database and ASCO meeting article were searched, and a meta-analysis was conducted. RESULTS Ten studies involving 4 084 patients were included for systematic reviews of toxicity. The incidence of neutropenia （RR=0.24, 95% CI： 0.14-0.41, P〈0.000 1） was higher in FOLFOX group, hand-foot syndrome （RR：3.60, 95% CI： 2.27-5.72, P〈0.000 1） and thrombocytopenia（RR=1.83, 95% CI： 1.36-2.48, P〈0.000 1） was higher in XELOX group. Nausea, vomiting, diarrhea and neuropathy were not significantly different between the two groups（P〉0.05）. CONCLUSION In metastatic colorectal cancer patients, FOLFOX and XELOX have their own advantages and disadvantages concerning with toxic reactions.

关 键 词：晚期结直肠癌 氟尿嘧啶 卡培他滨 奥沙利铂 系统评价 

分 类 号：R969.4[医药卫生—药理学]