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

摘要

Objective To compare the efficacy of capecitabine plus oxaliplatin(XELOX)and leucovorin(CF),5 - fluorouracil(5 -FU)and oxaliplatin(FOLFOX6)in treatment of patients with advanced colorectal cancer and incidence of adverse reactions in order to guide the treatment in these patients. Methods A total of 80 patients were divided into group X and group F according to the principle of voluntary basis with capecitabine and oxaliplatin therapy or leucovorin,5 - fluorouracil and oxaliplatin therapy,and the efficacy and adverse reactions in these 2 groups were statistically analyzed. Results CR,PR,NC and PD in patients of group X were 7,13,14 and 6 cases respectively,and the rate of response(RR)was 50. 0% ,and the rate of response(RR)in group F was 47. 5% ,there was no significant difference( P ﹥ 0. 05)in efficacy of treatment. In terms of adverse reactions,neurotoxicity,neutropenia,and thrombocytopenia in group X were significantly lower than those of group F( P ﹤ 0. 05),but the incidence of hand - foot syndrome in group X was significantly higher than that of group F( P ﹤ 0. 05). Conclu-sion The short term efficacy of capecitabine plus oxaliplatin and leucovorin plus 5 - fluorouracil was not significantly different in treatment of pa-tients with advanced colorectal cancer. In comparison with F program,program X is more convenient in application,in addition to the high inci-dence of hand - foot syndrome,but it can significantly reduce the incidence of adverse reactions,hence it is worthy to be considered in clinical pri-ority according to the specific circumstance of patients .%目的：比较卡培他滨联合奥沙利铂（XELOX）和亚叶酸钙（CF）、5-氟尿嘧啶（5- FU）联合奥沙利铂（FOLFOX6）治疗晚期结直肠癌的近期疗效和不良反应发生率，以指导晚期结直肠癌的治疗。方法将80例患者按照自愿原则分为 X 组和 F 组。X 组采用 XELOX 方案治疗，F 组采用 FOLFOX6方案治疗，统计两组的疗效和不良反应发生情况。结果 X 组完全缓解（CR）、部分缓解（PR）、无变化（NC）和进展（PD）分别有7例、13例、14例和6例，治疗有效率（RR）为50.0%，F 组治疗有效率为47.5%，两组治疗有效率比较无统计学差异（ P ﹥0.05）。在不良反应方面，X 组神经毒性、中性粒细胞减少、血小板减少发生率显著低于 F 组（ P ﹤0.05），但是手足综合征发生率明显高于 F 组（ P ﹤0.05）。结论 XELOX 和 FOLFOX6方案治疗晚期结直肠癌的近期疗效并无显著差异。相比于 F 方案，X 治疗方案用药更为方便，可以显著减少或并不增加除手足综合征外其他不良反应的发生，因此值得在临床中根据患者具体情况考虑优先使用。