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OBJECTIVE To mine the safety signals of FOLFOX scheme and FOLFIRI scheme-induced hepatotoxicity， and to provide reference for the selection of clinical rational treatment plan and the prevention and treatment of drug adverse reaction （ADR）. METHODS Reporting odds ratio method and proportion report ratio method were used to analyze adverse drug event （ADE） reports of FOLFOX scheme and FOLFIRI scheme in FDA adverse event reporting system during January 1， 2004-June 30， 2022. The potential safety signals of FOLFOX scheme and FOLFIRI scheme-induced hepatotoxicity were mined. RESULTS The amounts of ADE reports related to FOLFOX scheme and FOLFIRI scheme were respectively 3 454 and 1 359； the proportions of male and female patients involved were 1.50∶1 and 1.67∶1 in these two schemes， respectively. The top five countries with the largest number of reports were the United States， Japan， France， Italy and the United Kingdom， respectively accounting for 58.48% and 53.79% of the total reported cases. More than 90% of patients took no more than 5 drugs in combination， the proportion of patients receiving FOLFOX scheme and FOLFIRI scheme combined with anti-angiogenic drugs or epidermal growth factor receptor inhibitors was 45.45% and 86.82%， respectively. Totally 443 ADE reports of FOLFOX scheme-induced hepatotoxicity were collected， and 22 ADR signals were generated， including hepatic sinusoidal obstruction syndrome， nodular regenerative hyperplasia， drug-induced liver injury， blood bilirubin increased， etc. Totally 128 ADE reports of FOLFIRI scheme- induced hepatotoxicity were reported， and 9 ADR signals were generated， including blood bilirubin increased， hepatotoxicity， steatohepatitis， hepatic steatosis， etc. CONCLUSIONS FOLFOX scheme and FOLFIRI scheme can cause different types of hepatotoxicity. Clinical drug monitoring should be strengthened to guarantee drug safety.
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Primary liver cancer is the fourth most common malignancy and the second most common cause of cancer death in China, which poses a serious threat to the life and health of the Chinese people. Hepatocellular carcinoma (HCC) represents more than 90% of the pathology of primary liver cancer, among them around 60% of patients are at the intermediate-advanced stage when diagnosed. Therefore, increasing the rate of resection via conversion therapies is particularly important to improve the prognosis of these patients. Vascular interventional therapies represented by transarterial chemoembolization and hepatic arterial infusion chemotherapy are important treatment methods for HCC patients in intermediate-advanced stage, showing good rates of tumor response and surgical conversion. Combined with research data at home and abroad, the authors analyze research progress of vascular interventional therapy in the conversion therapy of HCC, review the history and the strategies of conversion therapies based on vascular interventional therapy in this article.
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@#[摘 要] 目的：探讨脾多肽联合FOLFOX4或XELOX方案用于Ⅲ/Ⅳ期结肠癌患者术后治疗的疗效及安全性。方法：回顾性收集选择2017年1月至2020年6月期间在广东省惠州市第六人民医院接受晚期结肠癌根治术的患者160例临床资料。将患者分为脾多肽注射液、奥沙利铂、亚叶酸钙联合氟尿嘧啶组[脾多肽+FOLFOX4组（脾F组），n=80]与脾多肽注射液、奥沙利铂联合卡培他滨组[脾多肽+XELOX组（脾X组），n=80]，两组患者均于手术后8周开始进行6个疗程的治疗，治疗结束1个月后对两组患者的临床疗效、免疫水平、营养状况、生存质量及不良反应等方面进行为期2年的随访观察。结果:与脾F组相比，脾X组患者的ORR和DCR均显著提高（均P<0.05）；CD3+ T、CD4+ T、NK细胞百分率、EORTC QLQ-C30评分和PNI水平均显著升高（均P<0.05），NLR、LMR、CA125、CA199、CEA均显著下降（均P<0.05）。脾X组患者白细胞或粒细胞减少、神经毒性、口腔黏膜炎和手足综合征等毒性作用和不良反应发生率均明显下降（均P<0.05）。两组患者2年PFS和OS无明显差异（均P>0.05）。结论: 在Ⅲ/Ⅳ期结肠癌术后患者的治疗中，脾多肽注射液联合XELOX方案比联合FOLFOX4方案在改善不良反应发生率和生活质量方面具有明显优势。
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@#Objective: To investigate the effects of XIAOJI Decoction combined with FOLFOX chemotherapy on serum cytokine expression profile in patients with advanced colorectal carcinoma by liquid chip technology. Methods: Fourteen patients with advanced colorectal carcinoma, who met the inclusion criteria and were treated in the Department of Oncology, Higher Education Mega Center Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine during January 1, 2018 and December 31, 2018 were retrospectively analyzed in this study. The patients were divided into chemotherapy group (n=7, treated with 5-Fluorouracil + Calcium Folic Acid+Oxaliplatin (FOLFOX)) and combined treatment group (n=7, treated with XIAOJI Decoction + FOLFOX) according to therapeutic scheme. The curative efficacy was evaluated after 6 treatment courses. The expression profile of cytokines in blood serum of patients was examined by liquid chip technology after every 2 courses. Results: Fourteen patients received a total of 84 cycles of therapy. Survival analyses showed that the progress-free survival time (PFS) and overall survival time (OS) of two groups couldn't be compared due to insufficient samples, although the combined treatment group had longer PFS (10 months vs 6 months) and OS (17 months vs 12 months) than the chemotherapy group.As to adverse reactions, the rates of leucopenia, diarrhea, nausea, peripheral neuritis and alopecia in two groups were comparable, while the severity in combined treatment group were lighter than that in chemotherapy group. In comparison with the combined treatment group, concentrations of serum BDNF and IL-2 were statistically higher in the chemotherapy group (P<0.05). By comparing the cytokine concentrations at different collection time points before and after the treatment, it showed that the concentration of serum IL-2 in chemotherapy group was higher than that in combined treatment group after 2 courses of treatment (P<0.05). In total, there were 19 cytokines showed a tendency to be higher in combined treatment group than chemotherapy group during different treatment periods. Conclusion: Combined treatment of XIAOJI Decoction with FOLFOX for advanced colorectal carcinoma is a treatment option worth exploring, and liquid chip analysis showed that the mechanism may be related to the reduction of serum LI-2 and BDNF levels in patients.
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PURPOSE: ATP-based chemotherapy response assay (ATP-CRA) is a well-documented and validated technology that can individualize chemotherapy. This study was undertaken to assess the usefulness of ATP-CRA in advanced colorectal cancer (CRC) patients receiving adjuvant chemotherapy. METHODS: A total of 136 patients with curative resection between January 2006 and April 2014 were evaluated using ATP-CRA. Patients received either the FOLFOX or Mayo clinic regimen chemotherapy following assay results. The sensitive-group (S-group) was defined as a drug-producing ≥ 40% reduction in ATP, and the resistant-group (R-group) as an ATP reduction of < 40%. These 2 groups were further subdivided to produce 4 subgroups: the FOLFOX sensitive subgroup (the FS subgroup [n = 65]), the Mayo sensitive subgroup (the MS subgroup [n = 40]), the FOLFOX resistant subgroup (the FR subgroup [n = 10]), and the Mayo resistant subgroup (the MR subgroup [n = 21]). Clinical responses and survival results were compared for both treatment regimens. RESULTS: The FS and MS subgroups showed a better disease-free survival rate (29% vs. 40%, 35% vs. 47.6%) and overall survival rate (92.3% vs. 80.0%, 87.5% vs. 76.2%) than FR and MR subgroups. The FS and MS subgroups showed a longer time to relapse (20.2 months vs. 9.5 months, 17.6 months vs. 16.4 months) than the FR and MR subgroups. CONCLUSION: ATP-CRA tailored-chemotherapy has the potential to provide a survival benefit in resectable advanced CRC.
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Humans , Adenosine Triphosphate , Adenosine , Chemotherapy, Adjuvant , Colorectal Neoplasms , Disease-Free Survival , Drug Screening Assays, Antitumor , Drug Therapy , Recurrence , Survival RateABSTRACT
PURPOSE: An oxaliplatin-based regimen is the most common adjuvant chemotherapy for patients with stage II/III colorectal cancer, but many patients experience dose reduction or early termination of chemotherapy due to side effects. We conducted this study to verify the range of reduction with oncologic safety. METHODS: Patients with stage II/III colorectal cancer who received adjuvant FOLFOX chemotherapy were enrolled in this study. The total amount of oxaliplatin administered per patient was calculated as a percentile based on 12 cycles of full-dose FOLFOX as a standard dose. The cutoff values showing significant differences in survival were calculated, and the clinicopathologic outcomes of patient groups classified by the value were compared. RESULTS: Among a total of 611 patients, there were 107 stage II patients, and 504 stage III patients. At 60% of the standard dose of oxaliplatin, the patients in the dose reduction group were older (62 years vs. 58 years, P = 0.003), had lower body mass index (BMI) (23.1 kg/m2 vs. 24.0 kg/m2, P = 0.005), and were more exposed to neoadjuvant treatment (18.0% vs. 9.1%, P = 0.003) in comparison to the standard group. At 60% of the standard dose, there were no significant differences in 5-year disease-free survival (DFS) and overall survival (OS) between the 2 groups (5-year DFS: 73.5% vs. 74.2%, P = 0.519; 5-year OS: 71.9% vs. 81.5%, P = 0.256, respectively). CONCLUSION: Patients with old age, low BMI, and more frequent exposure to neoadjuvant treatment tended to show lower compliance with chemotherapy. More than 60% dose should be administered to patients with stage II/III colorectal cancer as adjuvant chemotherapy to achieve acceptable oncologic outcomes.
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Humans , Body Mass Index , Chemotherapy, Adjuvant , Colorectal Neoplasms , Compliance , Disease-Free Survival , Drug Therapy , Neoadjuvant TherapyABSTRACT
PURPOSE: This study investigated how adding Korean red ginseng extract (KRG) to folinic acid, fluorouracil and oxaliplatin (FOLFOX) chemotherapy affected the rate of splenomegaly in colon cancer. METHODS: This retrospective study analyzed 42 patients who were randomly assigned to receive a FOLFOX regimen with or without KRG. Spleen volume change was assessed by computed tomography scans measured before surgery (presurgery volume) and 3 weeks after cessation of the 12th cycle of FOLFOX (postchemotherapy volume). RESULTS: All patients showed increased spleen volume. No difference was observed in median presurgery and postchemotherapy volume between the KRG and control groups. However, a ratio defined as postchemotherapy volume divided by presurgery volume was significantly lower in the KRG group than the control group (median, 1.38 [range, 1.0–2.8] in KRG group vs. median, 1.89 [range, 1.1–3.0] in control group, P = 0.028). When splenomegaly was defined as a >61% increase in spleen volume, the rate of splenomegaly was significantly lower in the KRG group than the control group (28.6% vs. 61.9%, P = 0.03). KRG consumption was inversely associated with developing splenomegaly in multivariate analysis. CONCLUSION: Adding KRG during FOLFOX chemotherapy for colon cancer might protect against oxaliplatin-induced splenomegaly. The protective effect of Korean red ginseng should be investigated with further research.
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Humans , Colon , Colonic Neoplasms , Drug Therapy , Fluorouracil , Leucovorin , Multivariate Analysis , Panax , Retrospective Studies , Spleen , SplenomegalyABSTRACT
Objective To explore the treatment for patients with advanced gastric cancer, the use of xiaoaiping injection combined with FOLFOX6 chemotherapy intervention. Methods 40 cases of patients with advanced gastric cancer for the implementation of FOLFOX6 chemotherapy intervention, at the same time as the control group, the other 40 patients in the control group based on the use of xiaoaiping injection, and classified as the observation group, two groups of patients were in our hospital from March 2015 to January 2017 . Results Comparing the two groups of patients with the treatment efficiency, the patients in the observation group were higher obviously; the observation group patients nursing satisfaction rate was significantly higher (P<0.05) shows significant differences. Compared two groups of patients with adverse reactions, found in the two groups were different, but the difference was not obvious. Conclusion The visible analysis of the effect of xiaoaiping injection combined with FOLFOX6 chemotherapy in the treatment of advanced gastric cancer, compared with chemotherapy and intervention The utility model has the advantages that the patient can be improved in time, and the clinical treatment effect can be improved, so that the utility model is worthy of clinical reference.
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Objective To investigate the effect of Avastin (bevacizumab) combined with preoperative FOLFOX neoadjuvant chemotherapy on the prognosis of patients with locally advanced rectal cancer (LARC).MethodsA total of 80 cases of patients with LARC treated with total mesorectal excision (TME) in our hospital from January 2013 to January 2016 were randomly divided into the control group and the observation group, 40 cases in each group.The control group were treated with preoperative FOLFOX chemotherapy while the observation group were treated with bevacizumab injection, based on the treatment in the control group.21 days was a cycle of chemotherapy, and both groups were treated for at least 4 cycles.After 6 cycles of chemotherapy, operation was carried out, following TEM principle.The short-term and long-term prognosis, rate of R0 resection, the incidence of postoperative complications and side effects of chemotherapy were compared between the two groups.ResultsThere was no significant difference between the two groups in the good response rate of chemotherapy, the rate of R0 resection, the incidence of postoperative complications, the 1-year and 3-year survival rates and 1-year disease-free survival rate.The incidence rates of gastrointestinal reactions and bone marrow suppression in the observation group were 52.5% and 52.5%, respectively while in the control group were 25.0% and 20.0%, respectively (P<0.05), but there was no significant difference in the incidence rates of grade Ⅲ~Ⅳ gastrointestinal reaction and bone marrow suppression between the observation group and the control group (5.0% and 15.0% vs 2.5% and 5.0%).The 3-year disease-free survival rate of the observation group was higher than that of the control group (82.5% vs 60.0%) (P<0.05).ConclusionThe application of bevacizumab combined with preoperative FOLFOX chemotherapy in the treatment of LARC can improve the 3-year disease-free survival rate, without increasing postoperative adverse reactions and serious side effects of chemotherapy.
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Objective To study the clinical effect of Kangaiping Wan on postoperative patients with colorectal cancer treated by FOLFOX chemotherapy.Methods 78 cases of colorectal cancer patients admitted from February 2014 to January 2015 in our hospital were selected and divided into observation group and control group according, 39 cases in each group.The control group was treated with FOLFOX4 regimen, and the patients in the observation group were treated with Kangaiping Wan on the basis of the control group.Two groups of patients before and after treatment of immune function improvement were compared, two groups of patients with clinical efficacy, quality of life to improve the situation, adverse reactions were compared.Results After treatment, the total effective rate of the observation group was significantly higher than the control group, the difference was statistically significant (P<0.05), quality of life of the observation group was significantly higher than the control group, the difference was statistically significant (P <0.05); There were no significant differences in the rates of oral mucositis, thrombocytopenia, hemoglobin, leukocytopenia and peripheral neurotoxicity in the two groups.The diarrhea and nausea and vomiting rate in the observation group were significantly lower than those in the control group (P<0.05).Conclusion FOLFOX regimen for patients with colorectal cancer after chemotherapy, combined with Kangaiping Wan, can effectively improve the clinical symptoms and quality of life of patients and enhance the immune function ,the clinical efficacy is good and the safety is high.
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Objective To investigate the survival rate and effects of life quality of palliative surgery combined with FOLFOX adjuvant chemotherapy on advanced rectal cancer treatment in elderly patients. Methods 100 elderly patients with advanced rectal cancer from May 2015 to May 2017, were randomly divided into the control group and the experimental group, 50 patients for each group. The control group was treated with palliative surgery. Patients in the experimental group were given palliative surgery and FOLFOX adjuvant chemotherapy. The survival rate and quality of life score were compared between the experimental and control groups. Results One year survival rate was 76% in the experimental group. One year survival rate was 52% in the control group. The survival rate of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05). After treatment, the total score of quality of life in the experimental group was (75.2 ± 11.2) points, and the total score of QOL in the control group was (64.2±9.3) points. The quality of life score of the control group was lower than that of the experimental group, with statistical difference (P<0.05). Conclusion Palliative surgery combined with FOLFOX adjuvant chemotherapy could significantly improve the survival rate of elderly patients with advanced rectal cancer and the quality of life.
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Objective To investigate the survival rate and effects of life quality of palliative surgery combined with FOLFOX adjuvant chemotherapy on advanced rectal cancer treatment in elderly patients. Methods 100 elderly patients with advanced rectal cancer from May 2015 to May 2017, were randomly divided into the control group and the experimental group, 50 patients for each group. The control group was treated with palliative surgery. Patients in the experimental group were given palliative surgery and FOLFOX adjuvant chemotherapy. The survival rate and quality of life score were compared between the experimental and control groups. Results One year survival rate was 76% in the experimental group. One year survival rate was 52% in the control group. The survival rate of the experimental group was significantly higher than that of the control group, with statistical difference (P<0.05). After treatment, the total score of quality of life in the experimental group was (75.2 ± 11.2) points, and the total score of QOL in the control group was (64.2±9.3) points. The quality of life score of the control group was lower than that of the experimental group, with statistical difference (P<0.05). Conclusion Palliative surgery combined with FOLFOX adjuvant chemotherapy could significantly improve the survival rate of elderly patients with advanced rectal cancer and the quality of life.
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PURPOSE: The optimal perioperative treatment for resectable esophageal squamous cell carcinoma (ESCC) remains controversial. We evaluated the efficacy and safety of leucovorin and 5-fluorouracil (LV5FU2) and LV5FU2 plus oxaliplatin (FOLFOX) combination chemotherapies administered adjuvantly for curatively-resected, node-positive ESCC. MATERIALS AND METHODS: Patients with pathologically node-positive esophageal cancer after curative R0 resection were enrolled and randomly assigned to receive LV5FU2 or FOLFOX biweekly for up to eight cycles. The primary endpoint was disease-free survival (DFS). RESULTS: Between 2011 and 2015, 62 patients were randomized into the two treatment groups (32 in the LV5FU2 arm and 30 in the FOLFOX arm). The median age was 60 years and both groups had similar pathologic characteristics in tumor, nodal status, and location. Treatment completion rates were similarly high in both groups. The DFS rate at 12 months was 67% in the LV5FU2 group and 63% in the FOLFOX group with a hazard ratio of 1.3 (95% confidence interval [CI], 0.66 to 2.62). After a median follow-up period of 27 months, the median DFS was 29.6 months (95% CI, 4.9 to 54.2) in the LV5FU2 arm and 16.8 months (95% CI, 7.5 to 26.1) in the FOLFOX arm (p=0.428), respectively, while the median overall survival was not reached in either arm. Grade 3 or 4 neutropenia was more frequent in patients in the FOLFOX arm than the LV5FU2 arm (20.0% vs. 3.1%). CONCLUSION: The addition of oxaliplatin (FOLFOX) did not lead to better efficacy compared to LV5FU2 chemotherapy in an adjuvant setting in node-positive ESCC patients.
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Humans , Arm , Carcinoma, Squamous Cell , Chemotherapy, Adjuvant , Disease-Free Survival , Drug Therapy , Drug Therapy, Combination , Epithelial Cells , Esophageal Neoplasms , Fluorouracil , Follow-Up Studies , Leucovorin , NeutropeniaABSTRACT
PURPOSE: The optimal perioperative treatment for resectable esophageal squamous cell carcinoma (ESCC) remains controversial. We evaluated the efficacy and safety of leucovorin and 5-fluorouracil (LV5FU2) and LV5FU2 plus oxaliplatin (FOLFOX) combination chemotherapies administered adjuvantly for curatively-resected, node-positive ESCC. MATERIALS AND METHODS: Patients with pathologically node-positive esophageal cancer after curative R0 resection were enrolled and randomly assigned to receive LV5FU2 or FOLFOX biweekly for up to eight cycles. The primary endpoint was disease-free survival (DFS). RESULTS: Between 2011 and 2015, 62 patients were randomized into the two treatment groups (32 in the LV5FU2 arm and 30 in the FOLFOX arm). The median age was 60 years and both groups had similar pathologic characteristics in tumor, nodal status, and location. Treatment completion rates were similarly high in both groups. The DFS rate at 12 months was 67% in the LV5FU2 group and 63% in the FOLFOX group with a hazard ratio of 1.3 (95% confidence interval [CI], 0.66 to 2.62). After a median follow-up period of 27 months, the median DFS was 29.6 months (95% CI, 4.9 to 54.2) in the LV5FU2 arm and 16.8 months (95% CI, 7.5 to 26.1) in the FOLFOX arm (p=0.428), respectively, while the median overall survival was not reached in either arm. Grade 3 or 4 neutropenia was more frequent in patients in the FOLFOX arm than the LV5FU2 arm (20.0% vs. 3.1%). CONCLUSION: The addition of oxaliplatin (FOLFOX) did not lead to better efficacy compared to LV5FU2 chemotherapy in an adjuvant setting in node-positive ESCC patients.
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Humans , Arm , Carcinoma, Squamous Cell , Chemotherapy, Adjuvant , Disease-Free Survival , Drug Therapy , Drug Therapy, Combination , Epithelial Cells , Esophageal Neoplasms , Fluorouracil , Follow-Up Studies , Leucovorin , NeutropeniaABSTRACT
OBJECTIVES: The addition of bevacizumab to standard chemotherapy has been improved survival outcomes in patients with metastatic colorectal cancer. However, the combination of bevacizumab with oxaliplatin-based chemotherapy as first-line treatment showed limited survival benefit. The purpose of this study was to investigate the clinical efficacy and toxicity of the combination of bevacizumab to oxaliplatin and leucovorin (FOLFOX4) in the first-line treatment of patient with metastatic colorectal cancer. METHODS: Between December 2004 and September 2009, medical records of patients who were diagnosed with metastatic colorectal cancer and received the first line chemotherapy with bevacizumab and FOLFOX4, were retrospectively reviewed. RESULTS: A total of forty patients were analyzed. The median age of the patients was 55 years (range, 33–80), and 55% was male. The patients received a total of 206 cycles of therapy (median 4 cycles per patient; range 1 – 15 cycles). Of these 40 patients, none achieved complete response (CR) and 15 achieved a partial response (PR), for the overall response rate (ORR) 37.5% (95% CI, 22.5–52.5). Median progression free survival (PFS) was 6.9 months (95% CI, 3.4–10.5) and median overall survival (OS) was 22.6 months (95% CI, 17.3–27.8The most common grade 3 or 4 hematologic toxicity and non-hematologic toxicity were neutropenia (10.0%) and diarrhea (10.0%), respectively. Two patients experienced gastrointestinal perforation. CONCLUSIONS: In this study, the combination bevacizumab with FOLFOX4 was associated with favorable OS, but did not showed favorable PFS and ORR.
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Humans , Male , Bevacizumab , Colorectal Neoplasms , Diarrhea , Disease-Free Survival , Drug Therapy , Leucovorin , Medical Records , Neutropenia , Retrospective Studies , Treatment OutcomeABSTRACT
PURPOSE: The survival of advanced colon cancer patients has increased due to the development of surgical techniques and adjuvant chemotherapy. The administration of adjuvant chemotherapy after curative resection is generally accepted as a standard of care. The primary endpoint of chemotherapy should include not only tumor response and survival, but also impact on the quality of life (QoL). We evaluated changes in QoL during adjuvant chemotherapy in patients with colon cancer.METHODS: Between October 2009 and February 2012, 56 patients with stage II and III colon cancer received the combination adjuvant chemotherapy 5-flurouracil/folinic acid with oxaliplatin (FOLFOX). Patients were asked to complete the QoL questionnaire QLQ-C30 version 3 before and after 6 cycles of adjuvant chemotherapy.RESULTS: There was no significant difference in the QoL between the start of chemotherapy and after the completion of 6 cycles. After completion of 6 cycles, global QoL was worse in patients >70 years of age. The functional scale score was low in patients with chemotherapy schedules delayed more than 2 times due to adverse events. Patients with body weight increases greater than 5% scored lower on symptom scales. Interestingly, patients with peripheral neuropathy scored higher on symptom scales.CONCLUSION: QoL changes during adjuvant chemotherapy did not show significant differences. After the sixth chemotherapy, QoL was affected by age, body weight gain, delay of the scheduled chemotherapy, and peripheral neuropathy. Therefore, the proper attitude of physicians focused on reassurance and education of patients is very important during chemotherapy.
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Humans , Appointments and Schedules , Body Weight , Chemotherapy, Adjuvant , Colon , Colonic Neoplasms , Drug Therapy , Patient Education as Topic , Peripheral Nervous System Diseases , Quality of Life , Standard of Care , Weights and MeasuresABSTRACT
Objective To investigate the effect of cetuximab combined with FOLFOX4 chemotherapy on expressions of cancer suppressor gene PTEN and P13K in colon cancer tissue of elderly patients.Methods 62 cases of elderly patients with colon cancer from October 2013 to July 2015 in our hospital were selected and divided into two groups according to the different therapy.The control group (n=27) received pure FOLFOX4 chemotherapy and treatment group(n=35)received cetuximab on the basis of FOLFOX4 chemotherapy, with a consecutive treatment of 4 courses.The clinical curative effect and expressions of PTEN and P13K in colon cancer tissue were compared between two groups.Results There were no significant difference in effective rate and disease control rate between treatment group and control group (51.4% vs.44.4%,χ2 =0.298,P=0.585;80.0%vs.62.9%,χ2 =2.223, P=0.136 ).After treatment, the cells positive rate of PTEN in treatment group was higher than that in control group post-treatment (82.86%vs.59.26%, P<0.05), and the cells positive rate of P13K in treatment group was lower than that in control group (37.14%vs.62.96%, P<0.05). Conclusion Cetuximab combined FOLFOX4 chemotherapy regimen could increase expression of PTEN and reduce P13K expression, which effect is remarkable in the treatment of elderly colon cancer.
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OBJECTIVE:To observe clinical efficacy of bevacizumab or cetuxizumab combined with FOLFOX4 regimen in the treatment of advanced rectal cancer. METHODS:114 patients with rectal cancer were randomly assigned to cetuxizumab group and bevacizumab group,with 57 cases in each group,among which one patient of bevacizumab group withdrew from therapy. Both groups received FOLFOX4 regimen:oxaliplatin 85 mg/m2+calcium folinate 200 mg/m2,ivgtt,2 h,and 5-FU 400 mg/m2,ivgtt, last,5-FU 600 mg/m2,ivgtt,22 h. Cetuxizumab group was additional given cetuxizumab 500 mg/m2;bevacizumab group was addi-tionally given bevacizumab 5 mg/kg,ivgtt. A treatment course lasted for 2 weeks. Both groups received 4 courses of treatment,and then clinical efficacy,toxic reaction and progression-free survival (PFS) were evaluated. RESULTS:Objective remission rate (RR),disease control rate(DCR)and median PFS of cetuxizumab group was 45.61%,92.98%and 10.0 months,those of bevaci-zumab group were 48.21%,87.50%and 11.0 months;there was no statistical significance between 2 groups(P>0.05). No signifi-cant differences were found in the incidence of ADR such as sensory neurotoxicity,aleucocytosis,thrombopenia,nausea and vomit-ing,diarrhea and erythra between 2 groups(P>0.05). CONCLUSIONS:Both bevacizumab or cetuxizumab combined with FOLF-OX4 regimen have a similar effect on patients with advanced cancer,with low incidence of toxic reaction.
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Objective To observe the effect and toxicity of oxaliplatin combined with calcium folinate and tegafur in the treatment of rectal cancer patients,in order to provide a safe and effective clinical program for rectal cancer treatment.Methods 117 rectal cancer patients conforming to the selection criteria were randomly divided into treatment group 59 cases and control group 58 cases by using random number method,treatment group were received chemotherapy of Oxaliplatin,calcium folinate and tegafur;control group were received FOLFOX4 program.After imple-mentation of two treatment plans,solid tumor curative effect evaluation standard from WHO was referenced to evaluate the curative effect.And toxicity classification was reached according to the WHO cancer drug toxicity assessment standard.Results Total effective rate of treatment group was 27.1%,total effective rate of control group was 29.3%,the comparative difference of two rates was not statistically significant (χ2 =0.069,P >0.05).The main symptoms of adverse reactions of two treatment plans were decreased of leukopenia,hemoglobin and thrombocytopenia of the blood system;nausea,vomiting,weak and abnormal liver function of the digestive system;,and limb numbness or pain of the nervous system.Adverse reactions difference in two groups was not significant (χ2 =0.106,0.158, 0.000,0.563,0.001,0.284,0.068,0.000,all P >0.05).After treatment,the median surial time was 15.5 months in treatment group and 16.5 months in control group,the difference of the median surial time in two groups was not statistically significant (P =0.781,P >0.05).Conclusion Combination of Oxaliplatin,calcium fluoride and tegafur is another safe and effective plan after the FOLFOX4 program in the treatment of rectal cancer drug application.
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Objective:To explore the infuence of calf spleen extractive injection combined with chemotherapy on immune function of the patients after colorectal carcinoma. Methods:Totally 128 cases of postoperative colorectal carcinoma patients were randomly di-vided into two groups with 64 ones in each. The control group only received FOLFOX 4 regimen, while the study group received calf spleen extractive injection additionally from the first day to the tenth day, 10ml, ivd, and 14-day was one cycle. After 4 weeks, im-mune function, peripheral blood leukocytes ( WBC) , hemoglobin ( Hb) and platelet ( Plt) in the two groups were compared, and the adverse reactions were evaluated as well. Results: After the treatment, CD3 +, CD4 +, CD8 + and CD4/CD8 were increased in the study groups, and those in the study group were much higher than those in the control group (P0. 05), while WBC and Plt in the study group were higher than those in the control group (P<0. 05). The incidence of adverse reactions in the study group was lower than that in the control group (P<0. 05). Conclusion:Calf spleen extractive injection combined with chemotherapy not only can increase the immune func-tion, but also alleviate myelosuppression and gastrointestinal toxicity in the treatment of postoperative colorectal carcinoma patients.