Hellenic Oncology Research Group (HORG), 55 Lomvardou str, 11470 Athens, Greece.
Crit Rev Oncol Hematol. 2010 Oct;76(1):61-70. doi: 10.1016/j.critrevonc.2009.08.003. Epub 2009 Sep 3.
A subgroup analysis of oxaliplatin (LOHP)+irinotecan (CPT-11)+5-fluorouracil (5FU) and leucovorin (LV) (FOLFOXIRI regimen) versus irinotecan+5FU/LV (FOLFIRI regimen) as first-line treatment of patients >65 years old with metastatic colorectal cancer is presented.
Eighty-two (56%) and 75 (55%) patients with metastatic colorectal cancer aged >65 years were enrolled in the FOLFOXIRI and FOLFIRI regimen, respectively.
There was no statistically statistical difference in terms of overall survival or time-to-tumor progression between young and aged patients between the two chemotherapy arms. The objective response rate was significantly lower in older patients treated with FOLFOXIRI (32% vs. 52%; OR: 1.45, 95% CI: 1.06-2.09; p=0.03). Elderly patients experienced a significantly higher incidence of grade 3/4 diarrhea compared to younger patients, irrespectively of the chemotherapy regimen (p=0.005 for FOLFIRI; p=0.017 for FOLFOXIRI). Dose reductions and treatment delays were more frequent in the FOLFOXIRI arm.
FOLFOXIRI does not seem to offer substantial benefit compared to FOLFIRI regimen in elderly patients with metastatic colorectal cancer.
本文报告了奥沙利铂（LOHP）+伊立替康（CPT-11）+5-氟尿嘧啶（5FU）和亚叶酸（LV）（FOLFOXIRI 方案）与伊立替康+5FU/LV（FOLFIRI 方案）一线治疗 65 岁以上转移性结直肠癌患者的亚组分析。
分别有 82（56%）和 75（55%）例 65 岁以上转移性结直肠癌患者入组 FOLFOXIRI 和 FOLFIRI 方案。
在这两种化疗方案中，年轻患者和老年患者的总生存期或肿瘤进展时间之间没有统计学差异。接受 FOLFOXIRI 治疗的老年患者的客观缓解率显著较低（32% vs. 52%；OR：1.45，95%CI：1.06-2.09；p=0.03）。与年轻患者相比，老年患者无论接受何种化疗方案，均更易发生 3/4 级腹泻（p=0.005 用于 FOLFIRI；p=0.017 用于 FOLFOXIRI）。FOLFOXIRI 组的剂量减少和治疗延迟更为频繁。
与 FOLFIRI 方案相比，FOLFOXIRI 并未为老年转移性结直肠癌患者带来明显获益。
