Fukui Taro, Suzuki Koichi, Ichida Kosuke, Takayama Yuji, Kakizawa Nao, Muto Yuta, Hasegawa Fumi, Watanabe Fumiaki, Kikugawa Rina, Saito Masaaki, Tsujinaka Shingo, Miyakura Yasuyuki, Rikiyama Toshiki
Department of Surgery, Saitama Medical Center, Jichi Medical University, Saitama, Saitama 330-8503, Japan.
Oncol Lett. 2017 Jun;13(6):4947-4952. doi: 10.3892/ol.2017.6100. Epub 2017 Apr 26.
Sequential administration of the chemotherapy regimes capecitabine and oxaliplatin (XELOX) and capecitabine and irinotecan (XELIRI) in the first- to second-line treatment setting would allow patients to be managed more easily in an outpatient unit. However, a small number of studies have raised concerns of cumulative adverse events as a consequence of the continuous use of capecitabine. To investigate this, the present study conducted a retrospective review of 81 consecutive metastatic colorectal cancer (mCRC) patients treated with the oxaliplatin, fluorouracil and leucovorin-irinotecan, fluorouracil and leucovorin (FOLFOX-FOFIRI/F-F) regimen (n=40) or the XELOX-XELIRI (X-X) regimen (n=41) in first- to second-line chemotherapy in Saitama Medical Center between 2006 and 2012. The disease control rate (DCR), the progression free survival (PFS), the overall survival (OS) and the time to failure of strategy (TFS) from first to second-line chemotherapy, as well as adverse events, were assessed and compared between patients receiving X-X or F-F. A total of 10 and 20 patients were additionally treated with bevacizumab in the F-F and X-X regimens, respectively, during first or second-line chemotherapy. There was no significant difference in DCR and the median PFS between the two regimens for first or second-line chemotherapy. There was no significant difference in the median OS and TFS between the two regimens (OS=24.5 and TFS=14 months in the F-F vs. 23.2 and 12.0 months in the X-X). Regarding adverse events, 45.0% of patients (18/40) exhibited grade 3-4 neutropenia throughout treatment with F-F. Whilst, 15.0% of patients (6/41) exhibited grade 3 hypertension throughout treatment with X-X, which was effectively controlled by a single antihypertensive drug. The results show that sequential administration of X-X is as effective and feasible as F-F treatment, while additionally reducing the frequency of infusion visits and eliminating the need for a central venous access device or home infusion pump, thereby offering a more convenient treatment option to patients with mCRC.
在一线至二线治疗中序贯给予化疗方案卡培他滨和奥沙利铂（XELOX）以及卡培他滨和伊立替康（XELIRI），将使患者在门诊科室更容易接受管理。然而，少数研究对持续使用卡培他滨导致的累积不良事件表示担忧。为了对此进行研究，本研究对2006年至2012年期间在埼玉医疗中心接受一线至二线化疗的81例连续转移性结直肠癌（mCRC）患者进行了回顾性分析，这些患者接受了奥沙利铂、氟尿嘧啶和亚叶酸 - 伊立替康、氟尿嘧啶和亚叶酸（FOLFOX - FOFIRI/F - F）方案（n = 40）或XELOX - XELIRI（X - X）方案（n = 41）治疗。评估并比较了接受X - X或F - F治疗的患者从一线至二线化疗的疾病控制率（DCR）、无进展生存期（PFS）、总生存期（OS）和治疗策略失败时间（TFS）以及不良事件。在F - F和X - X方案中，分别有10例和20例患者在一线或二线化疗期间额外接受了贝伐单抗治疗。两种一线或二线化疗方案的DCR和中位PFS无显著差异。两种方案的中位OS和TFS也无显著差异（F - F组的OS = 24.5个月，TFS = 14个月；X - X组的OS = 23.2个月，TFS = 12.0个月）。关于不良事件，在接受F - F治疗的患者中，45.0%（18/40）在整个治疗过程中出现3 - 4级中性粒细胞减少。而在接受X - X治疗的患者中，15.0%（6/41）在整个治疗过程中出现3级高血压，通过单一降压药物可有效控制。结果表明，序贯给予X - X与F - F治疗同样有效且可行，同时还减少了输液就诊次数，无需中心静脉通路装置或家庭输液泵，从而为mCRC患者提供了更便捷的治疗选择。
