Sequential administration of XELOX and XELIRI is effective, feasible and well tolerated by patients with metastatic colorectal cancer
Sequential administration of XELOX and XELIRI is effective, feasible and well tolerated by patients with metastatic colorectal cancer
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DOI：
10.3892/ol.2017.6100
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发表时间：
2017-06-01
期刊：
影响因子：
2.9
通讯作者：
Rikiyama, Toshiki
中科院分区：
文献类型：
--
作者：
Fukui, Taro;Suzuki, Koichi;Rikiyama, Toshiki
在一线至二线治疗环境中依次施用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) 将使患者在门诊病房更容易得到管理。然而，少数研究引起了对持续使用卡培他滨导致的累积不良事件的担忧。为了调查这一点，本研究对 81 名连续接受奥沙利铂、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) 一线至二线化疗的转移性结直肠癌 (mCRC) 患者进行了回顾性研究。埼玉医疗中心2006年至2012年期间。对接受X-X或F-F的患者进行疾病控制率（DCR）、无进展生存期（PFS）、总生存期（OS）和策略失败时间（TFS）以及不良事件的评估和比较。在一线或二线化疗期间，总共有 10 名和 20 名患者分别在 F-F 和 X-X 方案中额外接受贝伐单抗治疗。一线或二线化疗的两种方案之间的 DCR 和中位 PFS 没有显着差异。两种方案之间的中位 OS 和 TFS 无显着差异（F-F 中 OS=24.5 个月，TFS=14 个月，X-X 中 OS=23.2 个月和 12.0 个月）。关于不良事件，45.0% 的患者 (18/40) 在 F-F 治疗期间表现出 3-4 级中性粒细胞减少症。同时，15.0%的患者（6/41）在X-X治疗过程中出现3级高血压，单一抗高血压药物可有效控制病情。结果表明，X-X序贯给药与F-F治疗一样有效和可行，同时还减少了输液次数，无需中心静脉接入装置或家用输液泵，从而为转移性结直肠癌患者提供了更便捷的治疗选择。
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.