FOLFOX4与XELOX治疗晚期大肠癌临床对比观察

目的对比观察FOLFOX4方案与XELOX方案治疗晚期大肠癌的疗效和不良反应。方法将68例大肠癌患者分为FOLFO）14组和XELOX组。FOLFOX4组（40例）：奥沙利铂（OXA）85mg／m^2静滴2h，第1天；亚叶酸钙（LV）200mg／m^2静滴2h，第1～2天；5-氟尿嘧啶（5-Fu）400mg／m^2静脉注射。随后600mg／m^2持续静脉推注22h，第1～2天。每2周重复，4周为1个周期。XELOX组（28例）：奥沙利铂130mg/m^2。静滴，持续2h，第1天；卡培他滨1000mg／m^2口服，早晚各1次，第1～14天，3周或4周为1个周期。两组均至少连用2个周期评价疗效。结果FOLFOX4组40例，其中完全缓解（CR）0例（0），部分缓解（PR）16例（40．00％），稳定（SD）18例（45．00％），进展（PD）6例（15．00％），总有效率（RR）为40．00％．临床获益率（CBR）为85．00％；疾病进展时间（TTP）为（8．59±0．43）个月。XELOX组28例，CR0例（O），PR10例（35．71％），SD14例（50．00％），PD4例（14．29％），RR为35．71％，CBR为85．71％；TTP为（7．20±0．39）个月。两组TTP比较差异有统计学意义（P〈0．05）。毒副反应方面：FOLFOX4组白细胞、血小板减少、恶心呕吐的发生率明显高于XELOX组；而神经感觉毒性及手足综合征的发生．XELOX组明显高于FOLFOX4组，差异有统计学意义（P〈0．05）。毒副反应均能恢复和耐受，无化疗相关死亡。结论FOLFOX4方案与XELOX方案均为治疗晚期大肠癌有效的方案，FOLFOX4方案客观缓解率稍高，TTP显著长于XELOX组，毒副反应两组表现不一，但均可耐受。建议晚期大肠癌首选FOLFOX4方案，而其中体质欠佳、年龄偏大的患者宜选XELOX方案。

Clinical comparative observation of FOLFOX4 and XELOX in the treatment of advanced colorectal cancer

Objective To compare and observe the efficacy and toxicity of FOLFOX4 regimen and XELOX regimen in the treatment of advanced colorectal cancer. Methods 68 patients with colorectal cancer were divided into FOLFOX4 group and XELOX group. 40 cases of FOLFOX4 group： Oxaliplatin 85 mg/m2 as a 2-hour infusion in the first day and a 2-hour infu- sion of LV 200 mg/m2 followed by a 5-Fu 400 mg/m2 bolus and 600 mg/m2 22- hour infusion for 2 consecutive days every 2 weeks, every 4 weeks was a cycle. 28 cases of XELOX group： Oxaliplatin 130 mg/m2 as a 2-hour infusion in the first day, Capecitabin was orally given at a dose of 1 000 mg/m2, twice a day for two weeks, every 3 weeks or 4 weeks was a cycle. Ef- ficacy of the two groups was evaluated at 2 cycles. Results In 40 cases of FOLFOX4 group, there were 0 case （0） of CR, 16 cases （40.00%） of PR, 18 cases （45.00%） of SD, 6 cases （15.00%） of PD, the response rate （RR） was 40.00%, the clinical benefit rate （CBR） was 85.00%, TTP was （8.59±0.43） months. Meanwhile in the 28 cases of XELOX group, there were 0 case （0） of CR, 10 cases （35.71%） of PR, 14 cases （50.00%） of SD, 4 cases （14.29%） of PD, RR was 35.71%, CBR was 85.71%, TTP was （7.20±0.39） months. Significant differences were found in TTP between two groups （P 〈 0.05）. The inci- dence of bone marrow toxicity, nausea vomiting of FOLFOX4 group were higher than those of XELOX group （P 〈 0.05）, but peripheral nerve toxicity, and hand-foot syndrome of XELOX group were higher than those of FOLFOX4 group （P 〈 0.05）. The toxicity reactions of both groups could be recovered and tolerated. No correlated chemotherapy death occurred in all patients. Conclusion FOI,FOX4 regimen and XEI,OX regimen are effective regimens for treating advanced eoloreetal cancer. Nevertheless, overall response rate of FOLFOX4 is higher than XE1,OX, and TFP is significantly hmger than XEI,OX The Ioxieily reactions of Ihe two groups show different, while all can be tolerated. It is suggested that advanced colorectal cancer may choose FO1,FOX4 regimen first, in which, the aged cases with weak constitution may choose XELOX regimen.