Diao Chang, Cheng Ruo-Chuan, Zhang Jian-Ming, Wei Xiao-Ping, Su Yan-Jun, Liu Qi-Yu, Xu Jian-Biao
Department of General Surgery, The First Affiliated Hospital, Kunming Medical College, Kunming 650031, China.
Zhonghua Zhong Liu Za Zhi. 2008 Feb;30(2):147-50.
To evaluate the efficacy and safety of an adjuvant chemotherapy regimen: XELOX (Capecitabine puls Oxaliplatin) used after curative resection for stage III colorectal cancer.
From Jan. 1998 to Jan. 2004, 256 cases with stage III colorectal cancer randomized received de Gramont, modified FOLFOX4 (mFOLFOX4) and XELOX regimens. The 3-year disease-free survival (DFS) and overall survival (OS) were compared within the three groups and relative prognosis factors within mFOLFOX4 and XELOX groups. Therapeutic adverse events were recorded and analyzed with Kaplan-Meier test.
98, 87 and 71 cases were respectively enrolled in the de Gramont, mFOLFOX4 and XELOX groups, mFOLFOX4 and XELOX had superior efficacy compared with de Gramont regimen. The two former could significantly improve 3-year DFS (79.7% vs. 66.2%, P = 0.015; 81.5% vs. 66.2%, P = 0.004) and medium survival time (40.2 mon vs. 37.8 mon, P = 0.024; 41.4 mon vs. 37.8 mon, P = 0.014). Meanwhile they could respectively decrease the ratio of recurrence risk by 18.0% (P = 0.024) and 21.0% (P = 0.003). The relative benefit of mFOLFOX4 versus XELOX didn't differ for 3-year DFS [hazard ratio (HR): 0.84, 95% confidence interval (CI): 0.79-1.12, P = 0.13] and OS (HR: 0.87, 95% CI: 0.84-1.06, P = 0.54). In the analysis of DFS in relative prognosis factors, XELOX had a better trend of survival advantage. mFOLFOX4 had higher adverse events within these regimens, especially in grade 3 or 4 neutropenia and peripheral neurologic adverse events.
XELOX maintains its efficacy and safety ratio in advanced colorectal cancer. Patients have good tolerance and compliance. The regiment is deserves to be applied in clinical treatment. Oxaliplatin;
评估辅助化疗方案XELOX（卡培他滨联合奥沙利铂）用于Ⅲ期结直肠癌根治性切除术后的疗效和安全性。
1998年1月至2004年1月，256例Ⅲ期结直肠癌患者随机接受德格拉蒙、改良FOLFOX4（mFOLFOX4）和XELOX方案。比较三组的3年无病生存率（DFS）和总生存率（OS），以及mFOLFOX4组和XELOX组的相关预后因素。记录治疗不良事件并用Kaplan-Meier检验进行分析。
德格拉蒙组、mFOLFOX4组和XELOX组分别纳入98例、87例和71例患者，mFOLFOX4和XELOX方案的疗效优于德格拉蒙方案。前两者可显著提高3年DFS（79.7%对66.2%，P = 0.015；81.5%对66.2%，P = 0.004）和中位生存时间（40.2个月对37.8个月，P = 0.024；41.4个月对37.8个月，P = 0.014）。同时，它们可分别降低复发风险率18.0%（P = 0.024）和21.0%（P = 0.003）。mFOLFOX4与XELOX相比，3年DFS [风险比（HR）：0.84，95%置信区间（CI）：0.79 - 1.12，P = 0.13]和OS（HR：0.87，95% CI：0.84 - 1.06，P = 0. [54]）的相对获益无差异。在相对预后因素的DFS分析中，XELOX有更好的生存优势趋势。mFOLFOX4在这些方案中的不良事件发生率更高，尤其是3或4级中性粒细胞减少和周围神经不良事件。
XELOX在晚期结直肠癌中保持其疗效和安全性比值。患者耐受性和依从性良好。该方案值得在临床治疗中应用。奥沙利铂；
