Degirmencioglu Serkan, Tanrıverdi Ozgur, Demiray Atike Gokcen, Senol Hande, Dogu Gamze Gokoz, Yaren Arzu
1 Medical Oncology Department, Pamukkale University School of Medicine, Denizli, Turkey.
2 Medical Oncology Department, Mugla Sıtkı Kocman University School of Medicine, Mugla, Turkey.
J Int Med Res. 2019 Jun;47(6):2507-2515. doi: 10.1177/0300060519848258. Epub 2019 May 17.
This study aimed to evaluate the efficacy and safety profile of capecitabine and oxaliplatin (CAPOX) and 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) regimens as adjuvant treatment in patients with stage III colon cancer.
A total of 243 patients who received CAPOX and FOLFOX chemotherapy between 2014 and 2018 for stage III colon cancer in two centers were retrospectively studied. Among the patients, 106 (43.6%) and 137 (56.4%) were treated using CAPOX and FOLFOX regimens, respectively. Efficacy, treatment-related side effects, and overall survival rates with these two regimens were compared.
The rate of disease progression was significantly higher in the presence of moderately/poorly differentiated histology, and KRAS and NRAS mutations. An increased number of metastatic lymph nodes and prolonged time from surgery to chemotherapy significantly increased disease progression. Patients who received CAPOX were significantly older than those who received FOLFOX. Disease progression, metastasis, and mortality rates were significantly higher in the FOLFOX arm than in the CAPOX arm. There was no significant difference in the overall survival rate between the two regimens.
The CAPOX regimen is preferred in older patients. Disease progression, metastasis, and mortality rates are higher with FOLFOX than with CAPOX.
本研究旨在评估卡培他滨联合奥沙利铂（CAPOX）方案及氟尿嘧啶、亚叶酸钙和奥沙利铂（FOLFOX）方案作为Ⅲ期结肠癌患者辅助治疗的疗效和安全性。
回顾性研究2014年至2018年间在两个中心接受CAPOX和FOLFOX化疗的243例Ⅲ期结肠癌患者。其中，分别有106例（43.6%）和137例（56.4%）患者接受了CAPOX和FOLFOX方案治疗。比较了这两种方案的疗效、治疗相关副作用及总生存率。
在组织学分级为中/低分化、存在KRAS和NRAS突变的情况下，疾病进展率显著更高。转移淋巴结数量增加以及从手术到化疗的时间延长显著增加疾病进展。接受CAPOX治疗的患者比接受FOLFOX治疗的患者年龄显著更大。FOLFOX组的疾病进展、转移和死亡率显著高于CAPOX组。两种方案的总生存率无显著差异。
老年患者首选CAPOX方案。FOLFOX方案的疾病进展、转移和死亡率高于CAPOX方案。
