FOLFOX and FOLFOXIRI Regimens on Patients with Hepatic Metastasis from Colorectal Cancer after Operation
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摘要: 目的 比较FOLFOXIRI（folinic acid, 5-fluorouracil, oxaliplatin and irinotecan）和FOLFOX（folinic acid, 5-fluorouracil and oxaliplatin）两种化疗方案在肠癌肝转移同期手术切除患者中的有效性及安全性。方法 回顾性分析2008年1月至2011年7月结直肠癌伴肝转移同期手术切除患者60例，分为两组，分别接受FOLFOXIRI或FOLFOX两种化疗方案，观察不良反应以及1、2、3年无病生存期（DFS）和总生存期（OS），采用Kaplan-Merier进行生存分析。结果 接受FOLFOXIRI或FOLFOX两种化疗方案的60例患者，不良反应包括白细胞下降、血小板下降、贫血、恶心呕吐、腹泻、肝肾功能损害、神经毒性、口腔黏膜炎、脱发，FOLFOXIRI组在白细胞减少及腹泻方面有更高的不良事件发生率，其余不良反应与FOLFOX组相仿。两组患者1、2、3年无病生存率分别为73.3%、43.3%、26.7%和60%、13.3%、10%，其中2、3年DFS存在统计学差异。两组患者1、2、3年总生存率分别为86.7%、73.3%、36.7%和83.3%、50%、13.3%，其中3年OS差异有统计学意义（P=0.024）。结论 FOLFOXIRI和FOLFOX两种化疗方案安全有效，FOLFOXIRI组在白细胞减少及腹泻方面有更高的不良事件发生率，但更具远期生存优势。Abstract: Objective To compare the efficacy and safety of FOLFOXIRI(folinic acid, 5-fluorouracil, oxaliplatin and irinotecan) and FOLFOX(folinic acid, 5-fluorouracil and oxaliplatin) regimens on patients with hepatic metastasis from colorectal cancers after simultaneous resection. Methods We collected 60 patients with hepatic metastases from colorectal cancers who received simultaneous resection from January 2008 to July 2011. They were divided into two groups and received FOLFOXIRI or FOLFOX regimens. The incidence of adverse effects was recorded. The differences in 1-, 2-, 3-year disease-free survival(DFS) and overall survival(OS) were compared. The data was examined using Kaplan-Meier survival analysis. Results For 60 patients randomized to receive FLOFOXIRI or FOLFOX regimens, the adverse effects included leucopenia, thrombocytopenia, anemia, nausea, vomiting, diarrhea, liver and kidney function damage, neurotoxicity, oral mucositis and alopecia. FOLFOXIRI group had a higher incidence of leucopenia and diarrhea; other adverse effects were similar to FOLFOX group. The 1-, 2-, 3-year DFS rates of FOLFOXIRI group and FOLFOX group were 73.3%, 43.3%, 26.7% and 60%, 13.3%, 10% respectively, and there were significant differences in 2-, 3-year DFS(P=0.019, P=0.038); the 1-，2-，3-year OS were 86.7%, 73.3%, 36.7% and 83.3%, 50%, 13.3%, and there was a significant difference in 3-year OS(P=0.024). Conclusion FOLFOXIRI and FOLFOX chemotherapy regimens are safe and effective. FOLFOXIRI group has higher incidence of leucopenia, diarrhea and a better trend of long-term survival.
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Key words:
- Colorectal cancer /
- Oxaliplatin /
- Irinotecan /
- Adjuvant Chemotherapy
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[1] Siegel R, Desantis C, Jemal A. Colorectal cancer statistics, 2014[J]. CA Cancer J C1in, 2014, 64(2): 104-17. [2] Jones RP, Jackson R, Dunne DF, et al. Systematic review and meta-analysis of follow-up after hepatectomy for colorectal liver metastases[J]. Br J Surg, 2012, 99(4): 477-86. [3] Folprecht G, Hamann S, Schütte K, et al. Dose escalating study of cetuximab and 5-FU/folinic acid (FA)/oxaliplatin/irinotecan (FOLFOXIRI) in first line therapy of patients with metastatic colorectal cancer[J]. BMC Cancer, 2014, 14: 521. [4] Bibeau F, Gil H, Castan F, et al. Comment on 'Histopathologic evaluation of liver metastases from colorectal cancer in patients treated with FOLFOXIRI plus bevacizumab[J]. Br J Cancer, 2013, 10 9(12): 3127-29. [5] Loupakis F, Cremolini C, Masi G, et al. Initial therapy with FOLFOXIRI and bevacizumab for metastatic colorectal cancer[J]. N Engl J Med, 2014, 371(17): 1609-18. [6] Chua TC, Liauw W, Chu F, et al. Viewing metastatic colorectal cancer as a curable chronic disease[J]. Am J Clin Oncol, 2012, 35 (1): 77-80. [7] Saridaki Z, Androulakis N, Vardakis N, et al. A triplet combination with irinotecan (CPT-11), oxaliplatin (LOHP), continuous infusion 5- fluorouracil and leucovorin (FOLFOXIRI) plus cetuximab as first-line treatment in KRAS wt, metastatic colorectal cancer: a pilot phase II tria[J]. Br J Cancer, 2012, 107(12): 1932-7. [8] Souglakos J, AndroulakisN, Syrigos K, et al. FOLFOXIRI (folinic acid, 5-fluorouracil, oxaliplatin and irinotecan) vs. FOLFIRI(folinic acid, 5-fluorouracil and irinotecan) as firstline treatment in metastatic colorectal cancer(MCC): a multicentre randomized phase Ⅲ trial from the Hellenic Oncology Research Group(HORG)[J]. Br J Cancer, 2006, 94(6): 798-805. [9] Falcone A, Ricci S, Brunetti I, et al. Phase Ⅲ trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan(FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest[J]. J Clin Oncol, 2007, 25 (13): 1670-6. [10] Kawakami H, Satoh T, Nakagawa K. A review of FOLFOXIRI chemotherapy for the 1st line treatment of metastatic colorectal cancer[J]. Nihon Rinsho, 2011, 69(suppl 3): 439-45. [11] Montagnani F, Chiriatti A, Turrisi G, et al. A systematic review of FOLFOXIRI chemotherapy for the first-line treatment of metastatic colorectal cancer: improved efficacy at the cost of increased toxicity[J]. Colorectal Dis, 2011, 13(8): 846-52. [12] Schirripa M, Loupakis F, Pollina L, et al. Reply: Comment on 'Histopathologic evaluation of liver metastases from colorectal cancer patients treated with FOLFOXIRI plus bevacizumab[J]. Br J Cancer, 2013, 109(12): 3129-30.
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