Cheng Yuzhuo, Song Weiliang
Department of Surgery, Tianjin Third Central Hospital Tianjin City, China.
Int J Clin Exp Med. 2015 Oct 15;8(10):18713-20. eCollection 2015.
Chemotherapy with capecitabine combined with leucovorin, oxaliplatin, and irinotecan plus bevacizumab (XELOXIRI-Bev) or fluorouracil, leucovorin, oxaliplatin, and irinotecan plus bevacizumab (FOLFOXIRI-Bev), is recently introduced as first-line treatment for metastatic colorectal cancer (mCRC). The comparison between the two strategies above in clinical efficacy has not been assessed.
We retrospectively reviewed 138 patients with untreated metastatic colorectal cancer to receive either FOLFOXIR-Bev (group 1) or XELOXIRI-Bev (group 2). Up to 12 cycles of treatment were administered, followed by fluorouracil plus bevacizumab until disease progression. The primary end point was progression-free survival.
The mean progression-free survival was 13.5 months in the group 1, as compared with 10.4 months in the group 2 (hazard ratio for progression, 0.3; 95% confidence interval [CI], 0.12 to 0.83; P = 0.032). The objective response rate was 71% in the group 1 and 52.2% in the group 2 (P = 0.006). Overall survival was not found significant difference between the two groups (group 1 vs. 2; 31.3 vs. 24.6 months; hazard ratio for death, 0.6; 95% CI, 0.29 to 1.15; P = 0.115). The incidences of grade 3 or 4 neurotoxicity, stomatitis, diarrhea, and neutropenia were significantly higher in the group 1.
FOLFOXIR-Bev, as compared with XELOXIRI-Bev, improved the outcomes in patients with mCRC, but increased the incidence of some adverse events.
卡培他滨联合亚叶酸钙、奥沙利铂、伊立替康加贝伐单抗（XELOXIRI-Bev）或氟尿嘧啶、亚叶酸钙、奥沙利铂、伊立替康加贝伐单抗（FOLFOXIRI-Bev）的化疗方案，最近被引入作为转移性结直肠癌（mCRC）的一线治疗方案。上述两种方案在临床疗效方面的比较尚未得到评估。
我们回顾性分析了138例未经治疗的转移性结直肠癌患者，这些患者接受了FOLFOXIR-Bev（第1组）或XELOXIRI-Bev（第2组）治疗。给予最多12个周期的治疗，随后给予氟尿嘧啶加贝伐单抗直至疾病进展。主要终点是无进展生存期。
第1组的平均无进展生存期为13.5个月，而第2组为10.4个月（进展风险比为0.3；95%置信区间[CI]，0.12至0.83；P = 0.032）。第1组的客观缓解率为71%，第2组为52.2%（P = 0.006）。两组之间的总生存期未发现显著差异（第1组对第2组；31.3对24.6个月；死亡风险比为0.6；95%CI，0.29至1.15；P = 0.115）。第1组3级或4级神经毒性、口腔炎、腹泻和中性粒细胞减少的发生率显著更高。
与XELOXIRI-Bev相比，FOLFOXIR-Bev改善了mCRC患者的预后，但增加了一些不良事件的发生率。
