FOLFOX与XELOX方案治疗晚期结直肠癌毒性表现的系统评价

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。

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

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.