Clinical Study of Combining Chemotherapy of Oxaliplatin or 5-Fluorouracil/Leucovorin with Hydroxycamptothecine for Advanced Colorectal Cancer

摘要

OBJECTIVE To estimate the short-time efficacy, sideeffects, survival rate after the treatment of combiningchemotherapy of oxaliplatin or 5-fluorouracil/leucovorin withhydroxycamptothecine (HCPT) for the patients with advancedcolorectal cancer.METHODS From January 2002 to November 2005, 59 patientswith advanced colorectal cancer confirmed by pathology wereenrolled into this study in the department of medical oncology,in the Sixth People's Hospital of Shanghai Jiaotong University,Shanghai. Patients' characteristics in two groups were similarlyconfirmed by statistic. All 37 patients in OH group receivedoxaliplatin (130 mg/m^2 d1) plus hydroxycamptothecine (6mg/m^2 d1-4), and all 22 patients in the HLF group receivedhydroxycamptothecine (6 mg/m^2 d1-4) plus leucovorin (300 mgd1-5) and 5-fluorouracil (0.375 g/m^2 d1-5). The regimens in bothgroups were 21-day cycle that was repeated three weeks. The sideeffects were evaluated. The efficacy was estimated after two cyclesof chemotherapy for each patient.RESULTS The efficacy of the treatment in the OH group with37 patients and in the HLF group with 22 patients was estimated.The overall response rate (CR + PR) was 32.4% in the OH groupand 22.7% in the HLF group. There was no complete response(CR) and there was no statistical significantly difference (x^2= 0.876,P = 0.704) in two groups. The 1-year survival rate was 30.98%in the OH group and 15.02% in the HLF group, and it had nosignificant difference between the two groups. The median PSFand OS were 5.83 months and 11.17 months in the OH group vs.7.40 months and 10.48 months in the HLF group, and it had nosignificant differences between the two groups (P > 0.05). Themajor side effects of grade Ⅲ and Ⅳ in the two groups weremyelosuppression and gastrointestinal reactions. The statisticallysignificant difference in side effects appeared in leukopenia (x^2 =17.173, P = 0.001), nausea/vomiting (x^2= 6.426, P = 0.039), diarrhea(x^2 = 16.245, P = 0.000) and peripheral neuropathy.CONCLUSION The efficacy was almost equal between theOH and the HLF groups, and the two regimens can be usedas the second-line treatments for the patients with colorectalcancer. Leucopenia, nausea, diarrhea and peripheral neuropathyappeared more in OH group, and anemia and thrombocytopeniawere almost equal between the OH and the HLF groups.