奥沙利铂为主的联合化疗结合同期放射治疗晚期直肠癌

目的：评价奥沙利铂联合氟尿嘧啶、亚叶酸钙结合同期放疗的疗效。方法：奥沙利铂（L－OHP）130mg/m^2静脉滴注2小时，第1天；氟尿嘧（5－FU）300mg/m^2静脉滴注，第1－5天，亚叶酸钙（CF）200mg/m^2静脉滴注，第1－5天，21天为1周期，治疗3周期。放疗与化疗同期进行，体外照射全盆腔DT50－60GY／25－30次（5－6周）。结果：共治疗30例，近期疗效完全缓解（CR）1例；部分缓解（PR）15例；总有效率53．3％。一年生存率为70％（21／30）。主要毒副反应是消化道反应、神经毒性、放射性直肠炎，骨髓抑制轻微。结论：奥沙利铂为主的联合化疗结合同期放疗是治疗晚期直肠癌的有效方法。     

奥沙利铂为主的化疗方案治疗晚期胃癌的临床观察

目的：评价奥沙利铂（OXA）联合吡柔比星（THP）、亚叶酸钙（CF）和5-氟尿嘧啶（5-FU）治疗晚期胃癌的疗效和不良反应.方法：经病理学或细胞学检查确诊的34例晚期胃癌患者应用联合方案化疗,OXA70mg/m2,静脉滴注,第1,8天,THP40 mg/m2,静脉推注,第1天,CF100 mg静脉滴注,第1-5天;5-FU375mg/m2,静脉滴注,第1-5天.结果：34例晚期胃癌患者中,CR1例,PR18例,总有效率为55.9%.主要不良反应为恶心呕吐,外周神经感觉异常,骨髓抑制,脱发.结论：奥沙利铂联合吡柔比星、亚叶酸钙和5-氟尿嘧啶方案治疗晚期胃癌安全有效,不良反应可以耐受,值得临床进一步观察.     

奥沙利铂联合亚叶酸钙及5-氟尿嘧啶治疗晚期大肠癌的临床观察

目的 观察奥沙利铂（L-OHP）联合亚叶酸钙（CF）及5-氟尿嘧啶（5-Fu）治疗晚期大肠癌的疗效及不良反应。方法 奥沙利铂130mg/m^2静脉滴注2小时，第1天；亚叶酸钙200mg/m^2静脉滴注2小时,第1～5天；5-氟尿嘧啶500mg/m^2持续输注8小时以上,第1～5天；每3周重复。所有病人均接受3个周期以上的化疗。结果 全组CR 1例，PR 8例，SD 7例，PD 5例，总有效率42.9%。初治有效率50%，复治有效率33.3%。主要不良反应为轻度的外周神经毒性和恶心呕吐，骨髓抑制毒性轻。结论 奥沙利铂联合亚叶酸钙及5-氟尿嘧啶方案治疗晚期大肠癌有一定疗效，不良反应轻，值得临床推广应用。     

国产奥沙利铂联合亚叶酸钙及5-氟尿嘧啶治疗晚期大肠癌

 目的 观察国产奥沙利铂（L-OHP）联合亚叶酸钙（CF）、5-氟尿嘧啶（5-Fu）治疗晚期大肠癌的临床疗效和毒副反应，并将该方案和CF+5-Fu联合治疗方案相比较。方法 将64例患者随机分为两组，治疗组34例L-OHP 130 mg／m2，静脉滴注，第1天，CF 200 mg／m2，静脉滴注，第1 ~ 5天，5-Fu 500 mg／m2，静脉滴注，第1 ~ 5天，21 d为1个周期；对照组30例CF 200 mg／m2，静脉滴注，第1 ~ 5天，5-Fu 500 mg／m2，静脉滴注，第1 ~ 5天，21 d为1个周期。2周期后评定疗效。结果 治疗组有效率（CR+PR）为47.1 %，毒副反应主要为神经毒性，恶心、呕吐和白细胞下降；对照组CR+PR为20.0 %，毒副反应主要为恶心、呕吐和白细胞下降，无神经毒性。结论 国产L-OHP联合CF+5-Fu治疗晚期大肠癌，患者耐受良好，毒副反应较轻，疗效高于CF+5-Fu方案，是治疗晚期大肠癌安全有效的方案。     

草酸铂联合亚叶酸钙、5-氟尿嘧啶和羟喜树碱治疗进展期胃癌

 目的 观察草酸铂（L-OHP）联合亚叶酸钙（CF）、5-氟尿嘧啶（5-Fu）和羟喜树碱（HCPT）治疗晚期胃癌的疗效、临床受益反应和毒性。方法 42例均为Ⅳ期胃癌患者，化疗方案：L-OHP 130 mg／m2，静脉滴注，第1天；HCPT 6 mg／m2，静脉滴注，第1 ~ 5天，CF 200 mg／m2，静脉滴注，第1 ~ 4天；5-Fu总量2500 mg／m2，500 mg静脉推注，第1天，余量持续输注96 h，即第1 ~ 4天，21 d为1周期。结果 42例患者共完成148个周期化疗，CR 5例，PR 17例，SD 18例，PD 2例。有效（CR+PR）率53.28 %，临床受益率85.71 %，中位治疗进展时间7个月，1年生存率45.24 %。患者的主要毒副反应是恶心、呕吐和白细胞下降，未出现Ⅲ度以上神经毒性。结论 L-OHP联合CF、5-Fu和HCPT治疗晚期胃癌近期疗效和临床受益率高，毒副反应可耐受，值得广泛使用。     

奥沙利铂联合5-氟脲嘧啶／亚叶酸钙治疗晚期胃癌临床研究

目的：研究奥沙利铂联合5-氟脲嘧啶／亚叶酸钙治疗进展期胃癌的临床疗效及毒副反应。方法：将66例晚期胃癌患者随机分成两组，研究组33例，奥沙利铂130mg／m^2，静滴3小时，第一天给药；亚叶酸钙100mg，静滴2小时。第1—5天给药；5-氟脲嘧啶600mg／m^2，微量泵持续静脉灌注22小时，第1—5天给药。对照组33例，顺铂30mg／m^2，静脉滴注，第1—3天给药，亚叶酸钙和5．氟脲嘧啶用药方法同研究组。每3—4周为一周期。结果：研究组与对照组近期有效率分别为54．5％与42．4％，两组比较无统计学差异（P〉0．05）；研究组1年生存率及中位生存期均优于对照组，但无统计学差异（P〉0．05）；消化道反应发生率研究组低于对照组（P〈0．05）．外周神经毒性反应发生率研究组高于对照组（P〈0．01）。结论：研究组近期疗效、1年生存率及中位生存期均优于对照组，且消化道反应发生率明显低于对照组，值得临床进一步观察研究。     

草酸铂联合5-氟尿嘧啶治疗晚期胃癌临床观察

 目的 评价草酸铂（L-OHP）联合5-氟尿嘧啶（5-Fu）治疗晚期胃癌的疗效及其毒副反应。方法 L-OHP 130 mg／m2加入5 %葡萄糖注射液500 ml静脉滴注2 h，第1天；亚叶酸钙（CF）200 mg／m2静脉滴注2 h第1，2天；5-Fu 400 mg／m2静脉推注，第1，2天；5-Fu 600 mg／m2持续静脉滴注第1，2天， 21 d为1周期，完成2周期者复查有关指标，评价疗效和毒副作用。结果 全组可评价病例38例，其中完全缓解（CR）0例，部分缓解（PR）13例（34.2 %），无变化（NC）18例，进展（PD）7例，总有效（CR+PR）率34.2 %。毒副反应主要为中性粒细胞下降、静脉炎和神经毒性，患者消化系统不良反应轻微。结论 L-OHP联合CF／5-Fu方案治疗晚期胃癌效果好，毒性可以耐受，值得进一步应用和研究。     

奥沙利铂联合氟尿嘧啶和亚叶酸钙治疗晚期大肠癌

目的：研究奥沙利铂、氟尿嘧啶、亚叶酸钙联合治疗晚期大肠癌的疗效和毒性反应，并将该方案和氟尿嘧啶与亚叶酸钙联合治疗方案相比较。方法：经病理确诊的晚期大肠癌83例分为以下两组：治疗组行奥沙利铂(oxalipatin)130mg／m^2静脉滴注，第1天给药：氟尿嘧啶(5-FU)425mg／m^2静脉滴注，第1-5天给药；亚叶酸钙(CF)100mg／m^2静脉滴注，第1～5天给药；每3周重复。对照组行氟尿嘧啶(5-FU)42h5mg／m^2静脉滴注,第1～5天给药；亚叶酸钙(CF)100mg／m^2。静脉滴注，第1-5天给药；每3周重复。每例患者至少完成两个周期。结果：治疗组有效率为46．5％，常见的毒性反应为神经毒性；对照组有效率为17．5％，与治疗组差别有统计学意义，未见神经毒性，其他毒性与治疗组无统计学差异。结论：奥沙利铂联合氟尿嘧啶和亚叶酸钙治疗晚期大肠癌,患者对其耐受良好，毒副反应较轻，疗效高于氟尿嘧啶加亚叶酸钙方案。     

奥沙利铂联合氟尿嘧啶和亚叶酸钙治疗晚期大肠癌

目的:研究奥沙利铂、氟尿嘧啶、亚叶酸钙联合治疗晚期大肠癌的疗效和毒性反应,并将该方案和氟尿嘧啶与亚叶酸钙联合治疗方案相比较.方法:经病理确诊的晚期大肠癌83例分为以下两组:治疗组行奥沙利铂(oxaliplatin)130mg/m2静脉滴注,第1天给药;氟尿嘧啶(5-FU)425mg/m2静脉滴注,第1～5天给药;亚叶酸钙(CF)100mg/m2静脉滴注,第1～5天给药;每3周重复.对照组行氟尿嘧啶(5-FU)425mg/m2静脉滴注,第1～5天给药;亚叶酸钙(CF)100mg/m2静脉滴注,第1～5天给药;每3周重复.每例患者至少完成两个周期.结果:治疗组有效率为46.5%,常见的毒性反应为神经毒性;对照组有效率为17.5%,与治疗组差别有统计学意义,未见神经毒性,其他毒性与治疗组无统计学差异.结论:奥沙利铂联合氟尿嘧啶和亚叶酸钙治疗晚期大肠癌,患者对其耐受良好,毒副反应较轻,疗效高于氟尿嘧啶加亚叶酸钙方案.     

FOLFOX4方案联合顺铂腹腔双路热化疗并全身化疗治疗晚期胃癌38例

 目的　探讨FOLFOX4方案联合顺铂（DDP）腹腔双路热化疗并全身化疗治疗晚期胃癌的临床疗效和安全性。方法　选择38例经病理确诊并分期的晚期胃癌患者行FOLFOX4方案联合DDP腹腔双路热化疗并全身化疗，即行腹腔单点穿刺灌注40～42 ℃的0.9 %NaCl注射液2000～2500 ml + DDP 80～100 mg／m2＋地塞米松10 mg＋呋塞米40 mg的混合液，第1天腹腔注药后给予高频热疗机加热42～43 ℃维持1 h，隔日1次，共4次，在腹腔化疗前0.5 h起给予复方NaCl注射液1000 ml+硫代硫酸钠（STS）20～40 g静脉滴注（12 h），DDP与STS的比例为1∶200，次日STS的剂量减半，静脉滴注12 h，14 d为1周期；奥沙利铂（OXA）85 mg／m2静脉滴注（3 h）第1天；亚叶酸钙（CF）200 mg／m2静脉滴注（2 h）第1、2天；5-氟尿嘧啶（5-Fu）400 mg／m2静脉推注，5-Fu 600 mg／m2，持续静脉滴注22 h，14 d为1个周期，治疗4～6个周期后按WHO评定标准评价疗效和毒副作用。所有患者在应用OXA前1天起均给予硫酸镁、葡萄糖酸钙预防OXA的神经毒性。结果　全组38例患者均可评价疗效，总有效率52.6 %（20／38）。其中，初治18例，CR 3例，PR 9例，总有效率66.7 %；复治20例， 无CR，PR 8例，有效率40.0 %，患者不良反应主要为胃肠道反应、骨髓抑制和末梢神经毒性等。结论　FOLFOX4方案联合DDP腹腔双路热化疗并全身化疗治疗晚期胃癌，近期疗效确切，患者不良反应可耐受，值得进一步探讨。     

钙镁合剂预防奥沙利铂所致神经毒性的系统评价和Meta分析

  目的  评价静脉钙镁合剂对奥沙利铂所致的神经毒性的预防作用。   方法   查找使用奥沙利铂为基础的化疗方案, 并对比钙镁合剂和安慰剂预防神经毒性的随机对照研究。采用随机或者固定效应模型对资料进行Meta分析。   结果  共纳入16个临床研究, 981例患者。Meta分析显示钙镁合剂较安慰剂在预防奥沙利铂所致神经毒性上差异有统计学意义, 包括神经毒性的发生(P < 0.000 01)和 > I度的神经毒性(P < 0.000 01)。亚组分析表明: 钙镁至少均 > 1 g的合剂对预防奥沙利铂所致神经毒性有效。钙镁合剂与谷胱甘肽联合使用与安慰剂相比差异有统计学意义。   结论   钙镁合剂能有效预防奥沙利铂所致神经毒性, 与谷胱甘肽联合可能增加疗效。      

钙镁制剂和谷胱甘肽预防奥沙利铂所致神经毒性的效果观察

目的 评价钙镁制剂和谷胱甘肽(GSH)对奥沙利铂(OXL)引起的神经毒性的预防作用.方法 采用随机、双盲、安慰剂对照的方法,将接受FOLFOX4方案化疗的93例肿瘤患者随机分为3组,在化疗的同时分别给予钙镁制剂(29例)、GSH(33例)和生理盐水(3l例),观察每组神经毒性的发生率、严重程度以及患者的体力状况.结果 钙镁制剂组、GSH组和单纯化疗组急性神经毒性的发生率分别为82.8%、90.9%和93.5%,差异无统计学意义(均P>0.05).慢性神经毒性方面,化疗3个周期时,钙镁制剂组、GSH组和单纯化疗组1～2度神经毒性的发生率分别为37.9%、48.5%和42.0%,无3度神经毒性发生;化疗6个周期时,1～2度神经毒性的发生率分别为68.2%、88.9%和85.2%,5例患者出现3度神经毒性;化疗9个周期时,1～2度神经毒性的发生率分别为81.3%、90.0%和92.9%,又有2例出现3度神经毒性.3组1～2度神经毒性的发生率差异均无统计学意义(均P>0.05).化疗后,3组患者的美国东部肿瘤协作组(ECOG)评分变化相似,差异无统计学意义(P>0.05).结论 钙镁制剂和GSH对奥沙利铂引起的神经毒性无明显预防作用.     

钙镁输液预防奥沙利铂神经毒性的作用:一个Ⅲ期试验(英文)

Objective:This study is a prospective randomized, double-blind, placebo-controlled study to evaluate the effect of calcium and magnesium (Ca/Mg) infusion on amelioration of oxaliplatin neuropathy, the dose-limiting toxicity. Methods:Sixty patients with resected colorectal carcinoma (CRC) planned to receive adjuvant oxaliplatin-containing regimen were randomly assigned to two arms; Arm A:patients received Ca/Mg were given as 1 gm Ca gluconate and 1 gm MgSO 4 in 250 mL of intravenous (IV) solution over 30 min pre and post oxaliplatin infusion, and Arm B:patients received 250 mL of IV solution without Ca/Mg over 30 min pre and post oxaliplatin infusion. Primary outcome was to assess percentage of patients with oxaliplatin-induced neurotoxicity. Neurotoxicity was assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 3.0. Results:Sixty patients in both arms were assessed, 30 with Ca/Mg infusion and 30 without. Patients developed neurotoxicity in arm A were significantly lower than that in arm B after the end of treatment; 7 (23.3%) and 14 (46.6%) respectively (P < 0.05), and significantly lower duration of neuropathy in months (8 ± 2.5 vs 18 ± 3) respectively (P < 0.001). Conclusion:Use of IV Ca/Mg showed a statistically significant reduction of peripheral neuropathy (PN) in patients with CRC receiving oxaliplatin in the adjuvant settings.     

Reduction of oxaliplatin-related neurotoxicity by calcium and magnesium infusions

PURPOSE: Oxaliplatin in combination with infusional 5-fluorouracil/leucovorin (FOLFOX) have emerged as the standard of care in the therapy of advanced-stage colorectal cancer. Sensory neurotoxicity is its dose-limiting toxicity. We decided to use Ca and Mg for prevention of oxaliplatin-related neurotoxicity with reference to the report of Gamelin et al. METHODS: The subjects were 14 patients with metastatic colorectal cancer. Oxaliplatin (85 mg/m(2)) was given intravenously as FOLFOX regimen. All 14 patients received infusions of Ca gluconate and Mg sulfate before and after oxaliplatin. RESULTS: Only 1 patient had grade 3 toxicity (nausea and vomiting). Sensory neuropathy occurred in 8 patients (57.1%). There was no neurotoxicity with functional impairment in this study. Sensory neuropathy hardly occurred before 4 cycles. CONCLUSIONS: Ca/Mg infusions seem to prevent acute oxaliplatin-induced neurotoxic.     

Efficacy of venlafaxine for the prevention and relief of oxaliplatin-induced acute neurotoxicity: results of EFFOX,a randomized,double-blind,placebo-controlled phase III trial

BackgroundOxaliplatin neurosensory toxicity is dose limiting and may present as acute symptoms and/or cumulative peripheral neuropathy.Patients and methodsFrom October 2005 to May 2008, patients with oxaliplatin-induced acute neurotoxicity were randomized into a double-blind study, to receive either venlafaxine 50 mg 1 h prior oxaliplatin infusion and venlafaxine extended release 37.5 mg b.i.d. from day 2 to day 11 or placebo. Neurotoxicity was evaluated using numeric rating scale (NRS) for pain intensity and experienced relief under treatment, the Neuropathic Pain Symptom Inventory and the oxaliplatin-specific neurotoxicity scale. The primary end point was the percentage of patients with a 100% relief under treatment.ResultsForty-eight patients were included (27 males, median age: 67.6 years). Most patients had colorectal cancer (72.9%). Median number of cycles administered at inclusion was 4.5 (mean cumulative oxaliplatin dose: 684.6 mg). Twenty out of 24 patients in arm A (venlafaxine) and 22 out of 24 patients in arm B (placebo) were assessable for neurotoxicity. Based on the NRS, full relief was more frequent in the venlafaxine arm: 31.3% versus 5.3% (P = 0.03). Venlafaxine side-effects included grade 1–2 nausea (43.1%) and asthenia (39.2%) without grade 3–4 events.ConclusionsVenlafaxine has clinical activity against oxaliplatin-induced acute neurosensory toxicity.     

FOLFOX4方案治疗晚期结直肠癌的临床观察

  目的 评价FOLFOX4方案治疗晚期结直肠癌的临床疗效。方法 采用草酸铂（OXA）85 mg／m2，静脉滴注2 h，第1天；亚叶酸钙（LV）200 mg／m2，静脉滴注2 h，第1～2天；5-氟尿嘧啶（5-Fu）400 mg／m2，第1～2天静脉注射；5-Fu 600 mg／m2持续静脉滴注（22 h）第1～2天的方案治疗27例晚期结直肠癌。2周为1周期，重复4周期后间隔1个月评定疗效。结果 全组27例，CR1例（3.70 ％），PR11例（40.74 ％），总有效率（44.44 ％）。中位生存期10.0个月，平均生存期11.5个月，1年生存率30.02 %。12例治疗有效病例中位缓解期为5.3个月。治疗有效（CR+PR）病例、治疗无效病例的中位生存期分别为11.8，8.5个月。治疗有效病例的中位生存期显著好于无效病例（P＜0.05）。Ⅲ，Ⅳ度神经毒性发生率为14.81 ％，腹泻、黏膜炎及血液学毒性不影响治疗。结论 FOLFOX4方案治疗晚期结直肠癌有效安全，可作为晚期结直肠癌首选化疗方案。     

Neuroprotective effect of reduced glutathione on oxaliplatin-based chemotherapy in advanced colorectal cancer: a randomized, double-blind, placebo-controlled trial.

PURPOSE: We performed a randomized, double-blind, placebo-controlled trial to assess the efficacy of glutathione (GSH) in the prevention of oxaliplatin-induced neurotoxicity. PATIENTS AND METHODS: Fifty-two patients treated with a bimonthly oxaliplatin-based regimen were randomized to receive GSH (1,500 mg/m(2) over a 15-minute infusion period before oxaliplatin) or normal saline solution. Clinical neurologic evaluation and electrophysiologic investigations were performed at baseline and after four (oxaliplatin dose, 400 mg/m(2)), eight (oxaliplatin dose, 800 mg/m(2)), and 12 (oxaliplatin dose, 1,200 mg/m(2)) cycles of treatment. RESULTS: At the fourth cycle, seven patients showed clinically evident neuropathy in the GSH arm, whereas 11 patients in the placebo arm did. After the eighth cycle, nine of 21 assessable patients in the GSH arm suffered from neurotoxicity compared with 15 of 19 in the placebo arm. With regard to grade 2 to 4 National Cancer Institute common toxicity criteria, 11 patients experienced neuropathy in the placebo arm compared with only two patients in the GSH arm (P =.003). After 12 cycles, grade 2 to 4 neurotoxicity was observed in three patients in the GSH arm and in eight patients in the placebo arm (P =.004). The neurophysiologic investigations (sural sensory nerve conduction) showed a statistically significant reduction of the values in the placebo arm but not in the GSH arm. The response rate was 26.9% in the GSH arm and 23.1% in the placebo arm, showing no reduction in activity of oxaliplatin. CONCLUSION: This study provides evidence that GSH is a promising drug for the prevention of oxaliplatin-induced neuropathy, and that it does not reduce the clinical activity of oxaliplatin.     

Effects of Analgecine on Oxaliplatin-Induced Neurotoxicity in Patients with Gastrointestinal Cancer

Background: As the third generation of platinum-based antineoplastic agent aginst gastrointestinal cancer,oxaliplatin is considered to be associated with severe sensory neurotoxicity. Acorrding to previous studies,vitaminE, intravenous Ca/Mg and glutamine may partly reduce the incidence and severity of oxaliplatin-inducedneurotoxicity. The aim of this study was to investigate the safety and efficacy of analgecine for preventingoxaliplatin-induced neurotoxicity in the patients with gastrointestinal tumors. Method: In this study, patientsundergoing oxaliplatin-based chemotherapy were assigned to analgecine (experimental) group or controlgroup. Analgecine 6ml was administered once a day for seven days from the day of oxaliplatin treatment. TheNational Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE; version 3) was usedto evaluate oxaliplatin-induced neurotoxicity. The incidence rates and grade of neurotoxicity of patients wereassessed before and during (after four and eight cycles) treatment. Results: Totally, 82 patients were enrolled inthis study, 42 in experimental group and 40 in control group. The occurrence of each grade neurotoxicity in theexperimental group was significantly lower than that in control group. The overall occurrence rate was 31% vs55% (P=0.043) after 4 cycles and 52% vs 75% (P=0.050) after 8 cycles. Conclusion: Analgecine appears couldbe effective in reducing oxaliplatin-induced neurotoxicity and be applicated for patients with gastrointestinaltumors who would be treated with oxaliplatin-based chemotherapy.     

Ca/Mg infusions for the prevention of oxaliplatin-related neurotoxicity in patients with colorectal cancer: a meta-analysis

BackgroundOxaliplatin-related neurotoxicity is the main limitation for its continuation in adjuvant and palliative chemotherapy for patients with colorectal cancer. The purpose of this meta-analysis was to determine the efficacy of calcium and magnesium (Ca/Mg) infusions in oxaliplatin-induced neurotoxicity.MethodsTwo independent authors conducted database searches of the literature to find clinical-controlled trials analyzing Ca/Mg infusions in oxaliplatin-induced neurotoxicity. The keywords used to search were oxaliplatin, neurotoxicity, calcium, magnesium, neuropathy, and peripheral. Clinical studies that included at least one primary or secondary event were eligible for the analysis, where primary events were incidences of acute and cumulative neurotoxicity, and secondary events were the total doses and cycles of oxaliplatin, response rate (RR), overall survival (OS), and progression-free survival (PFS). Odds ratios (ORs) and weighted mean differences (MD) were analyzed using models of fixed and random effects.ResultsThis meta-analysis comprised four prospective randomized clinical trials and three retrospective clinical trials involving 1170 colorectal cancer patients, of which 802 received Ca/Mg infusions (Ca/Mg group) and 368 did not (control group). According to the National Cancer Institute-Common Terminology Criteria for Adverse Events, the incidence of grade 3 acute neurotoxicity in those who received Ca/Mg was significantly lower than that of the control group (OR = 0.26; 95% confidence interval (CI), 0.11 to 0.62; P = 0.0002). The total rate of cumulative neurotoxicity, and that of grade 3 in particular, was significantly lower in the Ca/Mg group than in the control group (OR = 0.42; 95% CI 0.26–0.65; P = 0.0001; OR = 0.60; 95% CI 0.39–0.92; P = 0.02, respectively). The differences in total doses and cycles of oxaliplatin were also significant between the Ca/Mg and control group (MD = 246.73 mg/m²; 95% CI 3.01–490.45; P = 0.05; MD = 1.55; 95% CI 0.46–2.63; P = 0.005, respectively). No significant differences were found in median PFS (MD = 0.71 month; 95% CI -0.59–2.01; P = 0.29), median OS (MD = 0.10 month; 95% CI -0.41–0.61; P = 0.70) or RRs (OR = 0.82; 95% CI 0.61–1.10; P = 0.18).ConclusionCa/Mg infusions tend to decrease the incidence of oxaliplatin-induced acute and cumulative neurotoxicity and thus enhance patients' tolerance to oxaliplatin, without significantly altering the efficacy of chemotherapy.     

Reduction of oxaliplatin-related neurotoxicity by Gosha-jinki-gan

PURPOSE: Oxaliplatin in combination with infusional 5-fluorouracil/Leucovorin (FOLFOX) has emerged as the treatment of choice for advanced-stage colorectal cancer. Sensory neurotoxicity is its dose-limiting toxicity. We decided to use Gosha-jinki-gan for prevention of oxaliplatin-related neurotoxicity following the report of Fushiki et al. METHODS: The subjects were 14 patients with metastatic colorectal cancer. Oxaliplatin (85 mg/m(2)) was given intravenously as a FOLFOX4 regimen. All 14 patients received Gosha-jinki-gan every day after first oxaliplatin infusion. RESULT: 7 patients had grade 3 toxicity(neutropenia 6, thrombocytopenia 1). Sensory neuropathy occurred in 10 patients (71.4%). There was no neurotoxicity with functional impairment in this study. CONCLUSIONS: Gosha-jinki-gan seems to prevent acute oxaliplatin-induced neurotoxicity.