Law Chi-Ching, Fu Yiu-Tung, Chau Kwok-Kwan, Choy Tim-Shing, So Ping-Fai, Wong Kam-Hung
Department of Clinical Oncology, Queen Elizabeth Hospital, 11/F, Block R, 30 Gascoigne Road, Kowloon, Hong Kong, China.
Dis Colon Rectum. 2007 Dec;50(12):2180-7. doi: 10.1007/s10350-007-9045-y.
The Xeloda in Adjuvant Cancer Therapy trial, conducted in a white population of patients, established capecitabine (Xeloda) as adjuvant chemotherapy for Stage III colon cancer. Given the ethnical difference in toxicity of adjuvant chemotherapy in colon cancer, this study was designed to evaluate the safety and efficacy of adjuvant capecitabine in Chinese patients with colon cancer.
Chinese patients with curatively resected Stage III colon adenocarcinoma, who received adjuvant capecitabine, were entered into a prospective database. Oral capecitabine was given at 1,250 mg/m(2) twice daily, Days 1 to 14, every 21 days, for 8 cycles. Toxicities, laboratory abnormalities, and survival outcomes were evaluated.
Fifty-eight patients were entered into the database between August 2004 and October 2005. The median age was 63.9 years with a male-to-female ratio of 1.15:1. With a median follow-up duration of 20.9 months, 14 patients relapsed and 3 patients died. Disease-free and overall survival at two years was 69 and 97 percent, respectively. Grade 3 toxicities occurred as follows: stomatitis (1.7 percent), diarrhea (0 percent), hand-foot syndrome (41.4 percent), leucopenia (1.7 percent), neutropenia (3.4 percent), and hyperbilirubinemia (1.7 percent). No Grade 4 or 5 toxicity was noted. Compared with the Xeloda in the Adjuvant Cancer Therapy trial, a much higher incidence of serious hand-foot syndrome and a lower rate of severe diarrhea were found in this study.
A different toxicity profile of adjuvant capecitabine was noted in this study on Chinese patients with colon cancer compared with that reported in the Xeloda in Adjuvant Cancer Therapy trial, whereas the efficacy outcomes were comparable.
希罗达辅助癌症治疗试验在白人患者群体中开展,确立了卡培他滨(希罗达)作为Ⅲ期结肠癌的辅助化疗药物。鉴于结肠癌辅助化疗毒性存在种族差异,本研究旨在评估卡培他滨辅助治疗中国结肠癌患者的安全性和疗效。
接受卡培他滨辅助治疗的中国Ⅲ期结肠腺癌根治性切除患者被纳入前瞻性数据库。口服卡培他滨,剂量为1250mg/m²,每日2次,第1至14天用药,每21天为1周期,共8个周期。评估毒性反应、实验室检查异常及生存结局。
2004年8月至2005年10月期间,58例患者被纳入数据库。中位年龄为63.9岁,男女比例为1.15:1。中位随访时间为20.9个月,14例患者复发,3例患者死亡。两年无病生存率和总生存率分别为69%和97%。3级毒性反应发生率如下:口腔炎(1.7%)、腹泻(0%)、手足综合征(41.4%)、白细胞减少(1.7%)、中性粒细胞减少(3.4%)和高胆红素血症(1.7%)。未观察到4级或5级毒性反应。与希罗达辅助癌症治疗试验相比,本研究中严重手足综合征的发生率更高,严重腹泻的发生率更低。
与希罗达辅助癌症治疗试验报道的情况相比,本研究中中国结肠癌患者辅助使用卡培他滨的毒性特征有所不同,而疗效结果相当。