XELOX与FOLFOX6方案一线治疗晚期结直肠癌的近期疗效及不良反应比较

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-氟尿嘧啶（5-FU）联合奥沙利铂（FOLFOX6）方案一线治疗晚期转移性结、直肠癌的疗效和不良反应。方法：将62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（capecitabine，Xeloda）1000mg／m^2，2次／d，口服，第1天至第14天；奥沙利铂（oxaliplatin）130mg／m^2，静脉滴注，持续3h，第1天；21天为1周期。FOLFOX6方案组（n=31）：亚叶酸钙（CF）200mg／m^2，静脉滴注，第1天，5-FU前；5-FU400mg／m^2，静脉推注，第1天，2400mg／m^2，静脉持续滴注46h；奥沙利铂100mg／m^2，静脉滴注，持续3h，第1天；14天为1周期。结果：XELOX组缓解率（RR）为48．4％，中位肿瘤进展时间（TTP）6．8个月；FOLFOX6组RR为51．6％，TTP为7．1个月；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组手足综合征发生率高于FOLFOX组，Ⅲ、Ⅳ度中性粒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，但XELOX方案用药更为方便，安全性更好。

Efficacy and side effect of XELOX and FOLFOX6 as first -line chemotherapy on metastatic colorectal cancer

Objective：To compare the clinical effects and toxicities of XELOX regimen and FOLFOX6 rigimen as the first - line chemotherapy on metastatic colorectal cancer. Methods ： Sixty two metastatic colorectal cancer patients were randomly assigned to two groups , XELOX and FOLFOX6 groups. In XELOX group, patients were treated with capecitabine 1000mg/m^2 oral twice everyday from day 1 to day 14;oxaliplatin 130mg/m^2 iv infusion for 3 hours on day 1, repeated every 3 weeks. In FOLFOX6 group, CF 200mg/m^2 iv infusion dl followed by 5 - FU 400mg/m^2 iv bolus on day 1 and 2400mg/m^2 iv infusion continuously for 46 hours;oxaliplatin 100mg/m^2 iv infusion for 3 hours on day 1 ,repeated every 2 weeks. Results： In XELOX group,the response rate （RR） was 48.4% ,the median time to progression （TIP） was 6.8 months. In FOLFOX6 group, RR was 51.6%, median TIP was 7.1 months （P 〉 0. 05 ）. There were more patients who developed hand - foot syndrome and less of grade Ⅲ, Ⅳ neutropenia in XELOX group. Conclusion： XELOX rigimen as first - line chemotherapy for metastatic colorectal cancer is as effective and tolerable as FOLFOX6 rigimen. But XELOX rigimen is more convenient and safe.