Comparison of capecitabine plus oxaliplatin with 5-fluorouracil/leucovorin(5-FU/LV) plus oxaliplatin in the treatment of 75 patients with advanced colorectal cancer

Objective: To compare the near efficacy and toxicity of oxaliplatin plus capecitabine(XELOX) regimen with oxaliplatin plus 5-fluorouracil/leucovorin(5-FU/LV)(FOLFOX4) regimen in the treatment of metastatic colorectal cancer.Methods: Totally 75 patients with metastatic and recurring colorectal cancer were enrolled into this study.Patients were randomly divided into XELOX(n=37) and FOLFOX4(n=38) groups.Patients in XELOX group were treated with capecitabine 1 000 mg·m-2,po,bid,for 14 days,and oxaliplatin 130 mg·m-2,ivgtt,on d 1.Patients in FOLFOX4 group were treated with oxaliplatin 85 mg·m-2,ivgtt,on d 1;LV 200 mg·m-2,ivgtt,for 2 h followed by 5-FU 400 mg·m-2(bolus) and 5-FU 600 mg·m-2(22 h-coutinous infusion),on d 1,2.XELOX regimen was repeated every 3 weeks for one cycle;FOLFOX4 regimen was repeated every 2 weeks,and 4 weeks for one cycle.All patients received two cycles of chemotherapy at least.The efficacy and toxicity were evaluated according to WHO standards.Results: All 75 patients were available for evaluating objective response.In XELOX group,the overall response rate was 48.6%(CR:3,PR:15);the median time to progression(TTP) was 6.12 months;the median survival time(MST) was 13.7 months.In FOLFOX4 group,the overall response rate was 50.0%(CR:3,PR:16);TTP was 5.91 months;MST was 13.9 months.The toxicities were well tolerated.In XELOX group,the major side effects were gastrointestinal tract reactions,myelosuppression,stomasitis,and alopecia;their incidence rates were significant lower than those in FOLFOX4 group(P0.05).The peripheral nerve toxicity and thrombocytopenia incidence rate were not significantly different between two group.The incidence rate of hand-foot syndrome was higher in XELOX group than in FOLFOX4 group(P0.05),but the severity was less(grade I~II).Conclusion: The response rate is not significantly different between the two regimens.XELOX regimen is safer and its use is more convenient than FOLFOX4 regimen.Thus,XELOX regimen is worth recommending as a first-line therapy for the treatment of advanced colorectal cancer patients.