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目的比较草酸铂联合氟尿嘧啶/亚叶酸钙(FOLFOX4)与草酸铂联合卡培他滨(XELOX)治疗晚期结直肠癌的临床疗效。方法将2007年1月-2011年12月收治的58例转移或复发晚期结直肠癌患者按照化学疗法(化疗)方案的不同分为两组,其中FOLFOX4组28例(男性患者占57.1%,平均年龄56.3岁),XELOX组30例(男性患者占63.3%,平均年龄57.8岁)。所有患者疗程不少于2个化疗周期,评价指标为病情缓解率和化疗药物的毒副作用。结果 FOLFOX4组完全缓解率(CR)和部分缓解率(PR)分别为10.7%(3/28)和32.1%(9/28),总有效率为42.8%(12/28);XELOX组CR和PR率分别为13.3%(4/30)和30.0%(9/30),总有效率为43.3%(13/30),两组总有效率差异无统计学意义(P=0.971)。XELOX组有10.0%(3/30)和16.7%(5/30)的患者分别出现中性粒细胞降低和神经毒性,但均显著低于FOLFOX4组[39.3%(11/28)、43.3%(13/30)](P=0.009,0.014)。XELOX组手足综合症发生率明显高于FOLFOX4组[40.0%(12/30)、14.5(4/28),P=0.029),但程度较轻,主要为Ⅰ～Ⅱ度。结论 XELOX与FOLFOX4化疗方案治疗晚期结直肠癌患者的疗效相似,但XELOX化疗方案毒副反应相对较小。
Objective To compare the clinical efficacy of oxaliplatin combined with fluorouracil / leucovorin (FOLFOX4) and oxaliplatin combined with capecitabine (XELOX) in the treatment of advanced colorectal cancer. Methods Fifty-eight patients with metastatic or recurrent advanced colorectal cancer who were treated from January 2007 to December 2011 were divided into two groups according to the chemotherapy (chemotherapy) regimen. Among them, 28 patients in FOLFOX4 group (57.1% in male patients, mean Age 56.3 years), XELOX group 30 cases (male patients accounted for 63.3%, mean age 57.8 years). All patients treated with not less than two cycles of chemotherapy, evaluation indicators for the rate of disease response and chemotherapy side effects. Results The complete response rate (CR) and partial response rate (PR) of FOLFOX4 group were 10.7% (3/28) and 32.1% (9/28), respectively. The total effective rate was 42.8% (12/28) PR rates were 13.3% (4/30) and 30.0% (9/30), respectively. The total effective rate was 43.3% (13/30). There was no significant difference in the total effective rate between the two groups (P = 0.971). Neutropenia and neurotoxicity occurred in 10.0% (3/30) and 16.7% (5/30) patients in the XELOX group, but were significantly lower than those in the FOLFOX4 group [39.3% (11/28) and 43.3% [ 13/30)] (P = 0.009, 0.014). The incidence of hand-foot syndrome in XELOX group was significantly higher than that in FOLFOX4 group [40.0% (12/30), 14.5 (4/28), P = 0.029), but to a lesser extent, mainly Ⅰ to Ⅱ degrees. Conclusions The efficacy of XELOX and FOLFOX4 chemotherapy for patients with advanced colorectal cancer is similar, but the side effects of XELOX chemotherapy are relatively small.