Feliu J, Vicent J M, García-Girón C, Constela M, Fonseca E, Aparicio J, Lomas M, Antón-Aparicio L, Dorta F J, Gonzalez-Baron M
Medical Oncology Service, Hospital La Paz de Madrid, Po de la Castellana, Madrid 261-28046, Spain.
Br J Cancer. 2004 Nov 15;91(10):1758-62. doi: 10.1038/sj.bjc.6602217.
The purpose of this study was to evaluate the efficacy, assessed as response rate, and toxicity of UFT (Tegafur-Uracil) in combination with oxaliplatin as first-line treatment of advanced colorectal cancer (CRC). In all, 84 patients with recurrent or metastatic CRC with measurable disease were included. Treatment consisted of oxaliplatin 85 mg m(-2) in 120-min intravenous (i.v.) infusion on days 1 and 15; i.v. l,leucovorin (l,LV) 250 mg m(-2) given in 2 h on day 1, followed by oral UFT 390 mg m(-2) on days 1-14, and oral l,LV 7.5 mg/12 h on days 2-14. Cycles were repeated every 28 days. A total of 492 cycles of chemotherapy were delivered with a median of six per patient (range 1-12). There was one complete response (1%) and 28 partial responses (34%) for an overall response rate of 35% (95% confidence interval (CI): 24-46%). A total of 36 patients (44%) had stable disease, whereas 17 (21%) had a progression. The median time to progression was 7.3 months and the median overall survival was 16.8 months. A prescheduled preliminary analysis was performed after inclusion of 16 patients who detected a high gastrointestinal toxicity, which led to a reduction of the UFT dose to 300 mg m(-2). With this new dosage, grade 3-4 diarrhoea and grade 3-4 nausea/vomiting dropped to 21 and 14% of patients, respectively. Other grade 3-4 toxicities were stomatitis in one (1%), anaemia in three (5%), neutropenia in two (3%), thrombocytopenia in one(1%), fatigue in six (9%), peripheral sensory neuropathy in nine (14%) and laryngopharyngeal dysesthesia in two patients (2%). The combination of oxaliplatin and UFT-l,LV is an active, easy-to-administer regimen with moderate toxicity. Hence, this regimen is worthy of further investigation.
本研究旨在评估优福定(替加氟-尿嘧啶)联合奥沙利铂作为晚期结直肠癌(CRC)一线治疗方案的疗效(以缓解率评估)和毒性。总共纳入了84例患有复发性或转移性CRC且疾病可测量的患者。治疗方案为:在第1天和第15天,奥沙利铂85 mg/m²静脉滴注120分钟;在第1天,亚叶酸钙(LV)250 mg/m²静脉滴注2小时,随后在第1 - 14天口服优福定390 mg/m²,在第2 - 14天口服LV 7.5 mg/12小时。每28天重复一个周期。总共进行了492个化疗周期,每位患者的中位数为6个周期(范围1 - 12个周期)。有1例完全缓解(1%)和28例部分缓解(34%),总缓解率为35%(95%置信区间(CI):24 - 46%)。共有36例患者(44%)疾病稳定,而17例(21%)疾病进展。疾病进展的中位时间为7.3个月,总生存的中位时间为16.8个月。在纳入16例患者后进行了预定的初步分析,这些患者出现了高胃肠道毒性,这导致优福定剂量降至300 mg/m²。采用这一新剂量后,3 - 4级腹泻和3 - 4级恶心/呕吐分别降至患者的21%和14%。其他3 - 4级毒性包括1例(1%)口腔炎、3例(5%)贫血、2例(3%)中性粒细胞减少、1例(1%)血小板减少、6例(9%)疲劳、9例(14%)周围感觉神经病变和2例患者(2%)咽喉感觉异常。奥沙利铂与优福定-LV的联合方案是一种有效且易于给药的方案,毒性中等。因此,该方案值得进一步研究。