Peripheral neurotoxicity of oxaliplatin in combination with 5-fluorouracil (FOLFOX) or capecitabine (XELOX): a prospective evaluation of 150 colorectal cancer patients
Andreas A. ArgyriouRoser VelascoChiara BrianiGuido CavalettiJordi BrunaPaola AlbertiMario CacciavillaniSara LonardiCristina SantosDiego CortinovisMarina Elena CazzanigaHaralabos P. Kalofonos
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Objective To investigate the efficacy and toxicity of Oxaliplatin combined with Capecitabine in treating advanced gastric cancer.Methods Oxaliplatin(130 mg/m2 ,intravenous infusion on day 1 for three hours) and Capecitabine(1000 mg/m2 ,per oral,twice daily for 14 days) were administered in a 21 days treatment course.All patients received at least two courses of treatment.Results Twenty-eight patients were enrolled in this study.All patients were included in the efficacy and adverse events analysis.There were no complete responses,twelve partial responses,giving an overall response rate of 42.8%.The major toxicity included myelotoxicity,peripheral neurotoxicity and hand-foot syndrome,all were generally mild.Conclusions Oxaliplatin combined with Capecitabine demonstrates clinical activity and an acceptable safety profile in patients with advanced gastric cancer.Clearly further investigation is warranted as we work.
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Objective To evaluate the efficacy and safety of Oxaliplatin in combination with capecitabine in treating advanced gastric cancer.Methods Thirty-five patients with advanced gastric cancer received chemotherapy: Oxaliplatin 100 mg/m~2 i.v,d1; combining oral capecitabine 2000mg/m~2.d (divided in two doses) d1-14; and repeated every 3 weeks.The efficacy and safety were assessed in every cycle.Results 2 cases (5.71%) achieved CR,13 cases (37.14%) had PR,10 cases (8.57%) had SD,10 cases (28.57%) had PD,with an overall response rate of 42.86%.The most common adverse effects were leucopenia,hand-foot syndrome,diarrhea and skin pigmentation.There was no treatment-related death.Conclusion Chemotherapy with oxaliplatin combined with capecitabine is effective and well-tolerated to the patients with advanced gastric cancer.
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Objective Comparative analysis the treatment effect of postoperation recurring gastric cancer about S1 and Capecitabine combined with Oxaliplatin. Methods The 26 patients which were postoperation recurring gastric cancer received and cured.Observed group (12 cases)cured with Oxaliplatin 30 mg/m2,D1, intravenous drip,S-1 selected 40mg～60mg/times about body surface area, 2 times/d, oral administration, D1~D14.Matched group (14 cases)cured with Oxaliplatin 30 mg/m2, D1, intravenous drip; Capecitabine applied 1500mg/times, 2 times/d, oral administration, D1~D14.Both the methods remedy cycles were 21 days.Effected assessment one times with two cycles, and follow-up visited the patients' condition.Results All the patients can be evaluated, the observed group's RR was 50% and the matched group's RR was 42.8%, they had no significant differences, but adverse effects and serious reactions of observed group were clearly under the matched group.Conclusion S-1 combined with Oxaliplatin was effective on advanced gastric cancer, and the adverse effects were tolerable.
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Oxaliplatin with 5-fluorouracil plus leucovorin (FOLFOX) has become the standard treatment in patients with colorectal cancer.Among known toxicities induced by oxaliplatin, hematological, gastrointestinal and neurological toxicities are common.However, acute pulmonary toxicity associated with oxaliplatin is unusual.One case of interstitial lung disease associated with the FOLFOX protocol is reported here.(
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fluorouracil＋folinate＋oxaliplatin（FOLFOX）療法が奏効し，経口摂取が可能となった腹膜播種を伴う切除不能進行胃癌の２例を経験した．症例１は66歳の男性で，食思不振，腹痛の精査で４型胃癌を指摘され，当院紹介となった．食道浸潤および腹膜播種をきたしていた．姑息手術による経口摂取改善は困難と考えられたが，全身状態は保たれており，FOLFOX療法を開始した．RECIST基準で部分奏効となり，腹水の消失および経口摂取の改善が得られた．症例２は73歳の女性で，経口摂取不良の精査で４型胃癌を指摘され，当院紹介となった．審査腹腔鏡にて多発腹膜播種を認め，FOLFOX療法を開始した．部分奏効となり，腹水の消失および経口摂取の改善が得られた．QOLの改善および予後改善という観点から，腹膜播種を伴う経口摂取不能の切除不能進行胃癌に対して，FOLFOX療法は有効な選択肢の一つと考える．
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目的：FOLFOX 是第三期大腸直腸癌術後標準輔助性化學治療。但是許多病人無法完成完整療程。本研究欲探討完成完整FOLFOX 療程的比率及其無法完成的原因。方法：由台北榮總大腸直腸外科資料庫收集2009 年一月至2015 年十二月第三期大腸直腸癌術後接受FOLFOX 治療之病人之基本資料、接受Oxaliplatin 之劑量及無法完成之原因做分析。結果：研究期間內內共866 個第三期大腸直腸癌病人接受手術。其中110 人沒有接受後續輔助性化學藥物治療，199 人接受其他療法，5 人於其他他醫院治療。最後收集572人分析。290 人 (50.6%) 完成完整療程，其Oxaliplatin 累計計劑量之中位數為984 mg/m^2(644~1210 mg/m^2)。無法完成完整療程的病人中，78 人 (27.7%) 是因為主治醫師預防性停藥，72 人 (25.5%) 因週邊神經病變，30 人 (10.6%) 因疾病進展更換療法，18 人 (6.4%)因對Oxaliplatin 過敏，19 人 (6.7%) 因為白血球過低過肝腎功能惡化，17 人 (6.0%) 因嚴重噁心嘔吐，12 人 (4.3%) 因為整體身體狀況變差，36 人 (12.8%) 自行要求停藥。因週邊神經病變而中斷治療的患者，其Oxaliplatin 的累積劑量中位數為746 mg/m^2，而因對Oxaliplatin 過敏中斷治療的患者，其累積劑量中位數為680.4 mg/m^2。結論：半數病人能完成完整療程，週邊神經病變及及醫師預防性停藥是無法完成完整療程之主因。研發預防或減緩週邊神經經病變副作用之化學治療方法應能增加完整療程達成率。
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Objective We evaluated the antitumour activity and toxicities of oxaliplatin and capecitabine as therapy in geriatric patients with advanced gastric cancer(AGC).Methods Patients were treated with capecitabine 1000mg/m2 p.o.twice daily on days 1-14 and oxaliplatin 120mg/m2 i.v.on day 1 every 3 weeks until disease progression or unacceptable toxicities.Results 1 patient showed complete response and 12 showed partial response.The overall response rate 56.4%.Major toxicity was myelosuppression,enteric reaction and hand-foot syndrome.Conclusion Oxaliplatin and capecitabine combination chemotherapy is active and highly tolerable as a therapy for geriatric patients with AGC.
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Objective: To observe the safety and curative effects of treating advanced gastric cancer with combined capecitabine and oxaliplatin.Methods: Thirty two patients with advanced gastric cancer were treated with capecitabine and oxaliplatin for two courses to observe the curative effects,clinical profit,toxic reactions and side effects.Results: The total effective rate reached 56.3%.The patients who hade clinical profit were 84.3% and with slight toxic reactions and side effects,no patients dead for toxic reactions of chemotherapy. Conclusion: The chemotherapy with capecitabine and oxaliplatin combined has more advantages in treating advanced gastric cancer.It is more effective,more convenient and with slight toxic reactions and side effects is an effective chemotherapy regimen for advanced gastric cancer.
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［背景］Oxaliplatinは，日本で合成された第3 世代の白金錯体系の抗悪性腫瘍剤であり，欧米ではOxaliplatin と持続投与5-FU/LV 併用（FOLFOX 療法）が進行再発大腸癌に対する標準的な化学療法としての地位を確立し広く施行されている。本邦では，2005 年4 月にOxaliplatinが承認され，当院でも切除不能進行・再発大腸癌に対するfirst-lineの化学療法としてFOLFOX 療法を積極的に施行している。［方法］2005 年6 月より2007 年8 月までに切除不能進行・再発大腸癌に対し，first-line としてFOLFOX4 およびmFOLFOX6 を施行した23 例を対象とし，その効果・安全性を検討した。FOLFOX4 は13 例に，mFOLFOX6は10 例に施行された。［結果］奏効率は50.0％であり，全生存期間は17.4 か月であった。投与回数の中央値は8.0，Oxaliplatinのrelative dose intensityは74.5％である。有害事象は，血液毒性ではGrade 3 以上の白血球減少を4 例，好中球減少を12 例に認め，非血液毒性ではGrade 3 の消化器毒性を1 例，Grade 3 の末梢神経障害を1例に認めたのみであった。［結語］FOLFOX 療法は，日本人においても進行再発大腸癌に対するfirst-lineの化学療法として比較的高い奏効性と安全性をもつ治療法であることが確認された。
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Oxaliplatin with 5-fluorouracil plus leucovorin (FOLFOX) has become the standard treatment in patients with colorectal cancer. Among known toxicities induced by oxaliplatin, hematological, gastrointestinal and neurological toxicities are common. However, acute pulmonary toxicity associated with oxaliplatin is unusual. One case of interstitial lung disease associated with the FOLFOX protocol is reported here. (Korean J Gastroenterol 2010;55: 340-343)
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