Comella P, Massidda B, Palmeri S, Farris A, Lucia L De, Natale D, Maiorino L, Tafuto S, Cataldis G De, Casaretti R
Division of Medical Oncology A, Department of Medicine, National Tumour Institute, Naples, Italy.
Cancer Chemother Pharmacol. 2005 Nov;56(5):481-6. doi: 10.1007/s00280-005-1003-6. Epub 2005 May 18.
Oxaliplatin 100 mg/m(2) iv on day 1, and capecitabine 1,000 mg/m(2) orally bid from day 1 (evening) to day 11 (morning) were administered every 2 weeks (OXXEL regimen) to 38 patients as first-line treatment for metastatic colorectal carcinoma. A total of 318 cycles were administered, with a median of 8 (range, 4-12) cycles per patient. Response rate (RR) was 45% (95% confidence interval (CI), 29%-62%), with 7 complete responses and 10 partial responses; furthermore, 12 patients showed a stable disease, so that a disease control was achieved in 29 (76%) patients. RR was greater among patients with performance status 0 (52%), without weight loss (52%), younger than 65 years (50%), and previously unexposed to adjuvant chemotherapy (48%), while no correlation was found with the actually delivered oxaliplatin dose intensity. Overall, haematological side effects were negligible, with no case of grade 4 toxicity, and only one patient suffering from an episode of grade 3 neutropenic fever. Severe anaemia occurred in 4 (11%) patients, and grade 3 neuropathy affected 9 (24%) patients. Median progression-free survival was 7.9 (95% CI, 6.2-9.6) months, and median overall survival has not been reached yet. In conclusion, the OXXEL regimen resulted safe and active, and it deserves further evaluation in metastatic colorectal cancer patients.
第1天静脉注射奥沙利铂100mg/m²,从第1天(晚上)至第11天(早上)口服卡培他滨1000mg/m²,每日2次,每2周对38例患者进行一次给药(OXXEL方案),作为转移性结直肠癌的一线治疗。共进行了318个周期的给药,每位患者的中位周期数为8个(范围4 - 12个)。缓解率(RR)为45%(95%置信区间(CI),29% - 62%),其中7例完全缓解,10例部分缓解;此外,12例患者疾病稳定,因此29例(76%)患者实现了疾病控制。在体能状态为0的患者(52%)、无体重减轻的患者(52%)、年龄小于65岁的患者(50%)以及先前未接受过辅助化疗的患者(48%)中,RR更高,而未发现与实际给予的奥沙利铂剂量强度存在相关性。总体而言,血液学副作用可忽略不计,无4级毒性病例,仅有1例患者发生3级中性粒细胞减少性发热。4例(11%)患者出现严重贫血,9例(24%)患者出现3级神经病变。中位无进展生存期为7.9个月(95% CI,6.2 - 9.6),中位总生存期尚未达到。总之,OXXEL方案安全有效,值得对转移性结直肠癌患者进行进一步评估。