- 期刊
Oxaliplatin in Combination with 5-Fluorouracil and Leucovorin as Second-Line Therapy for Metastatic Colorectal Cancer
以Oxaliplatin合併5-Fluorouracil和Leucovorin作為轉移性大腸直腸癌第二線藥物的治療
摘要
目的 Oxaliplatin合併5-fluorouracil和leucovorin後，能有效治療轉移性大腸直腸癌。在台灣，其治療效果和毒性尚未有資料報告。因此我們發表本院以合併oxaliplatin，高劑量5- FU和leucovorin作為轉移性大腸直腸癌第二線藥物治療的最早結果。方法 從1999年10月到2002年6月，回溯性分析在本院單一醫學中心接受此項治療的南台灣轉移性大腸直腸癌的病患。此項兩星期一次的治療包括第一天oxaliplatin(85mg/m^2)，leucovorin(100 mg/m^2)和第一，二天的5-FU(infusion 1500 mg/m^2)。結果 50位病患被納入評估，接受總共420次，中位數9次的治療。46位接受化療後客觀X光評估中，總反應率為17%(完全0%，部份17%)。無惡化存活時間中位數為8.8個月，整體存活時間為13個月。在第三或第四度毒性方面，嘔吐8(16%)；低血小板4(8%)；低白血球3(6%)；腹瀉2(4%)；過敏2(4%)；低白血球發燒1(2%)；神經毒性2(4%)；胃炎1(2%)；牙關緊閉1(2%)。第二度掉髮2(4%)。引起第三度神經毒性的中位數療程為10次。結論 一般而言，oxaliplatin合併5-fluorouracil和 leucovorin的治療,對於台灣的病患有不錯的療效和可接受的毒性。第三、四度的神經毒性和低白血球發燒在這區域性的研究中相當少見。
並列摘要
Background and Aims. Oxaliplatin is an effective agent in metastatic colorectal cancer (MCRC) with infusion 5-Fluorouracil(5-FU) and Leucovorin(LV). The efficacy and toxicity profiles of the combination have not been reported in Taiwan. We presented the preliminary data of the combination of Oxaliplatin, high dose infusional 5-FU and LV as second- line chemotherapy for metastatic colorectal cancer at Chang Gung Memorial Hospital in Kaohsiung. Methods. A retrospective analysis of consecutive patients (Oct. 1999 to June 2002) with MCRC was conducted in a single medical center to assess efficacy and toxicity of the combination as 2nd line treatment for MCRC in a southern Taiwan population. The 2-weekly regimen comprised Oxaliplatin (85 mg/m^2, D1) with leucovorin (100 mg/m^2, D1) and 5-FU (infusion 1500 mg/m^2, D1+2). Results. Fifty patients were evaluated with a total 420 cycles and a median 9 cycles of combined treatment. The total response rate was 17% (complete 0%, partial 17%) in 46 patients receiving objective radiology evaluation after chemotherapy. The median progression free survival was 8.8 months and the median overall survival was 13 months. Grade III or IV toxicity: vomiting 8 (16%); thrombocytopenia 4 (8%); neutropenia 3 (6%); diarrhea 2 (4%); allergy 2 (4%); neutropenic fever 1 (2%); neuropathy 2 (4%); stomatitis 1 (2%); trismus 1 ( 2%). Grade 2 alopecia was noted in 2 (4%) patients. The median cycle of oxaliplatin to induce Grade III neuropathy was 10 cycles. Conclusion. Oxaliplatin in combination with 5-FU and LV is generally well tolerated in Taiwanese patients with expected good efficacy and acceptable toxicity. Grade 3/4 neuropathy and neutropenic fever were infrequently encountered in this subtropical series.