Treatment of advanced colorectal cancer with chemotherapy and recombinant human endostatin in the window period / 中国肿瘤临床

Objective: To observe the effect of recombinant human endostatin (endostar) combined with chemotherapy on advanced colorectal cancer. Methods: A total of 120 inoperable patients with advanced colorectal cancer who were admitted to the Guizhou Cancer Hospital from June 2014 to June 2018 were selected. The patients were divided into two groups. Sixty cases were allocated to the test group and received endostar of 15 mg/d, d1-d7, which was repeated after 7 and 14 days. Chemotherapy was initiated on the 5th day of endostar (endostar window period). Sixty patients were allocated to the control group and received endostar of 15 mg/d, d1-d14, which was repeated after 7 and 21 days. Chemotherapy was initiated on the 1st day of endostar. The chemotherapy regimen used was mFOLFOX6 or FOLFIRI. Results: The objective response rate (ORR) of the test and control groups was 25.0%, and 18.3%, respectively, and the disease control rate (DCR) was 80.0% and 73.3%, respectively. The difference was not significant (P=0.375, P= 0.388). The 1-year survival rate of the test group and the control group was 69.6% and 62.5%, respectively, while the 2-year survival rate was 39.7% and 21.3%, respectively. Moreover, the 3-year survival rate was 26.8% and 13.3%, respectively, and the median survival time was 22 months (95% CI 16.817-27.183) and 16 months (95% CI 11.890-20.110), respectively. In contrast to the control group, the survival rate increased and the survival time was prolonged in the test group (P=0.033). The progression time (TTP) of median disease in the test and control groups was 9 months and 8 months, respectively. This was not statistically significant (P>0.05). Conclusions: This study found that chemotherapy with recombinant human endostatin in the window stage can enhance the 1, 2, and 3-year survival rate of patients with advanced colorectal cancer, as well as prolong the median survival time.

Effect of XELOX regimens plus combination of endostar and thalidamide as first?line treatment for advanced colorectal cancer / 中国综合临床

Objective To investigate the efficacy and safety of two antiangiogenic drugs (recombinant human endostatin endostar and thalidomide ) combined with capecitabine and oxaliplatin (XELOX) regimens in the treatment of advanced colorectal cancer.Methods From January 2015 to May 2018,40 patients of advanced metastatic colorectal cancer with organ metastasis and non?resectable were selected from the first people′s hospital of Hefei and Anhui Provincial Hospital, and they were randomly divided into treatment and control group, with 20 cases in each group.The treatment group received intravenous infusion (IV) of endostar for continuous 7 days (day 1～7) combined with oral administration of thalidomide for continuous 14 days (day 1～14) plus XELOX regimens after the fifth dose of endostar (day 6～19),and the control group was treated with XELOX regimen (day6～19).Results The objective response rate (ORR) was 50%(10／20) and 20%(4／20) respectively (χ2＝3.956,P＜0.05),the disease control rate (DCR) was 85%( 17／20) and 70%(14／20) respectively ( χ2＝1.290,P＞0.05),and the median progression free survival (mPFS) was 6.8 in both groups.There was no significant difference in Karnofsky performance score ( KPS) and incidence of adverse reactions between the two groups before and after treatment (P＞0.05).Conclusion Combination of endostar and thalidamide plus XELOX regimen as first?line treatment have better antitumor activity and are well?tolerated in patients with advanced colorectal cancer.

Relationship between plasma concentration of fluorouracil and the chemotherapy efficacy and prognosis in patients with advanced colorectal cancer / 中华检验医学杂志

Objective To detect the plasma concentration of fluorouracil in patients with advanced colorectal cancer who uesd fluorouracil , and to explore the relationship between chemotherapy efficacy , tumor response, toxicity and survival of patients with advanced colorectal cancer after chemotherapy with fluorouracil.Methods 174 patients with advanced colorectal cancer were collected from the General Hospital of Ningxia Medical University from January 2014 to December 2016.Patients with advanced colorectal cancer were treated with FOLFOX scheme , venous blood was taken from patients 18-24 hours after intravenous infusion of fluorouracil .The concentration of 5-FU in blood was measured by nami-enhanced immune assay.The targeted AUC range of 5-FU was 20-30 mg· h/L.The patients were divied into three groups-targeted range group , lower than the targeted range group and higher than the targeted range group . The therapeutic efficacy, toxicity and survival of patients were recorded , in order to observe the difference of different target range groups.To analyze the correlation between the different target groups and the clinical characteristics,a logistic method was used.Chi-square test was used to compare the efficacy and toxicity of the three groups.The survival curves were plotted by kaplan-meier method. Results To detected the concentration of fluorouracil at the same time after infusion of fluorouracil .The AUC was 2.267-31.06 mg· h/L,it was very different, the median AUC was 15.368 mg· h/L, and the highest AUC was 31.06 mg· h/L,it was 13.7 times that of the lowest blood concentration (2.267 mg· h/L) .The relationship between the concentration of fluorouracil and the clinical indicators was found as follows :(1)Clinical characteristics : the blood concentration of 5-Fu after infusion was different , which was related to the preoperative CEA status (r＝0.318,P＜0.05), EGFR(r＝0.558,P＜0.05), Lymph node metastasis status(r＝0.325,P＜0.05), and the number of metastatic organs ( r＝0.404, P＜0.05 ) .( 2 ) Effect of chemotherapy : There were significant differences in the effect of chemotherapy between different target groups (χ2＝6.78,P＜0.05). The effect of chemotherapy in the targeted range group was lower than that in the target range group , and the difference has statistically significant(χ2＝2.030,P＜0.05).(3)toxicity: there have statistical difference among the three groups,the toxicity of higher targeted range group was higher than the other two groups (χ2＝2.01,P＜0.05).(4)Survival: The survival time of patients with targeted range group was lower than that of targeted range group, and the difference has statistically significant (χ2＝7.263,P＜0.05).Conclusion The method of testing the concentration of fluorouracil in patients with advanced colorectal cancer is valuable to predict the efficacy , toxicity and prognosis of patients with colorectal cancer.

Relationship between the Asp1104His polymorphism of the nucleotide excision repair gene ERCC5 and treatment sensitivity to oxaliplatin in patients with advanced colorectal cancer in China

OBJECTIVES: To study the relationship between the Asp1104His polymorphism of the nucleotide excision repair gene ERCC5 and treatment sensitivity to oxaliplatin in patients with advanced colorectal cancer (CRC) in China. METHODS: A group of 226 patients in the Department of Gastrointestinal Oncology at Zhejiang Xiaoshan Hospital from July 2011∼December 2016 and a control group of 226 normal healthy individuals were involved in this study. All patients were first diagnosed with advanced CRC and were treated with oxaliplatin-based chemotherapy. The genotype of ERCC5 at the site of amino acid 1104 was determined by a TaqMan probe-based real-time PCR approach. RESULTS: There were no differences in age or gender between the groups, but the percentages of smokers and individuals with a family history of cancer were significantly higher in the patient group than in the control group. Analysis of the G/C polymorphism frequency among the patients and the healthy controls showed that the frequencies of the CC genotype and the CC+GC genotype were significantly related to CRC, but no significant difference in these frequencies was found between genders. The analysis of the relationship between the 5-year survival rate and different genotypes showed that in the total patient group, regardless of gender, the 5-year survival rate was significantly associated with the Asp1104His polymorphism of ERCC5. CONCLUSIONS: The Asp1104His polymorphism of ERCC5 was associated with the risk and 5-year survival rate of CRC as well as treatment sensitivity to oxaliplatin.

Analysis of efficacy of pemetrexed or fluorouracil combined with irinotecan in the treatment of advanced colorectal cancer / 中国生化药物杂志

Objective To study the efficacy of pemetrexed or fluorouracil in combination with irinotecan in the treatment of advanced colorectal cancer. Methods 68 patients with advanced colorectal cancer were selected from January 2014 to January 2016 in Qinghai Provincial People's hospital. Patients were divided into the control group and the observation group by random grouping, and 34 patients for each group. Patients in the control group were received second-line therapy with fluorouracil and irinotecan. The patients in the observation group were received second-line therapy with the combination of pemetrexed and irinotecan. After treatment, the treatment effects, adverse reactions and living conditions of two groups were compared. Results The total effective rate of the observation group was 38.24%, was higher than that of the control group 8.82% (P<0.05); the observation group's disease control rate was 76.47%, was higher than that of the control group 52.94% (P<0.05). The incidence of adverse reactions in the observation group was 200.00%, which was lower than 305.88% in the control group (P<0.05). Progression free survival time in the observation groupwas (6.81±2.31) months, was higher than the control group (3.75±1.06) months (P<0.05); the total survival time in the observation group was (14.69±4.28) month, was higher than the control group (8.76±2.27) month (P<0.05). Conclusion In the second-line treatment of advanced colorectal cancer, the application of raltitrexed combined with irinotecan treatment, could improve the total efficiency of treatment and disease control rate, reduce adverse reactions, and prolong the survival time of patients.

Curative effect of oxaliplatin combined with S-1 in treatment of advanced colorectal cancer / 药物评价研究

Objective To analyze the curative effect of oxaliplatin combined with S-1 in the treatment of advanced colorectal cancer.Methods Totally 90 cases of patients with advanced colorectal cancer in Shangluo No.2 Provincial People's Hospital from January 2013 to August 2015 were divided into observation group and control group,45 cases in each group.Patients in control group were treated with oxaliplatin combined with fluorouracil,4 weeks for one cycle of treatment,and patients in observation group were treated with oxaliplatin combined with S-l,21 d for one cycle.The curative effects,adverse reactions,life quality,and one year survival rate were compared between two groups.Results After treatment,the total remission rate of observation group was higher than that of control group,and the disease control rate was lower than that of the control group,but there was no significant difference between the two groups.During the treatment,there were no significant differences in Ⅰ degree and Ⅱ degree adverse reactions between two groups;But the adverse reactions of level Ⅲ and level Ⅳ of gastrointestinal reaction,liver function damage,reduce the incidence of white blood cells in observation group were significantly lower than that of control group (P ＜ 0.05).There was no significant difference between the two groups in the SF-36 scale scores.The one year survival rate of observation group was (21/45),and the survival rate of the control group after treatment was 42.22％ (19/45) in the control group,and there was no significant difference between the two groups in the one year survival rate.Conclusion Compared with oxaliplatin combined with fluorouracil,oxaliplatin combined with S-1 has equivalent efficacy and life quality,but the adverse reactions in gastrointestinal tract,liver,and marrow were better.

Analysis of efficacy of pemetrexed or fluorouracil combined with irinotecan in the treatment of advanced colorectal cancer / 中国生化药物杂志

Objective To study the efficacy of pemetrexed or fluorouracil in combination with irinotecan in the treatment of advanced colorectal cancer. Methods 68 patients with advanced colorectal cancer were selected from January 2014 to January 2016 in Qinghai Provincial People's hospital. Patients were divided into the control group and the observation group by random grouping, and 34 patients for each group. Patients in the control group were received second-line therapy with fluorouracil and irinotecan. The patients in the observation group were received second-line therapy with the combination of pemetrexed and irinotecan. After treatment, the treatment effects, adverse reactions and living conditions of two groups were compared. Results The total effective rate of the observation group was 38.24%, was higher than that of the control group 8.82% (P<0.05); the observation group's disease control rate was 76.47%, was higher than that of the control group 52.94% (P<0.05). The incidence of adverse reactions in the observation group was 200.00%, which was lower than 305.88% in the control group (P<0.05). Progression free survival time in the observation groupwas (6.81±2.31) months, was higher than the control group (3.75±1.06) months (P<0.05); the total survival time in the observation group was (14.69±4.28) month, was higher than the control group (8.76±2.27) month (P<0.05). Conclusion In the second-line treatment of advanced colorectal cancer, the application of raltitrexed combined with irinotecan treatment, could improve the total efficiency of treatment and disease control rate, reduce adverse reactions, and prolong the survival time of patients.

Dominated by nutrition specialist nurses the intervention of the quality of life in patients with ;advanced colorectal cancer chemotherapy / 中国实用护理杂志

Objective To evaluate the nutrition intervention on advanced colorectal cancer chemotherapy patients quality of life. Methods 70 colorectal cancer patients (NRS 2002 score was more than or equal to 3 points) with chemotherapy from January 1st, 2013 to June 31th, 2014 were collected. The patients were randomly divided into intervention group (35 patients) and the control group (35 patients). The intervention group received personalized recipe which was developed by a team containing nurse specialist, chief psychiatrist, family members and patients themselves. The control group was treated with a normal diet guidance. The two groups of patients when they were treated after the second days of the first admission (before intervention), the end of the 6th courses of chemotherapy and the 12th courses of chemotherapy were evaluated by the European Organization For Research and Treatment Quality of Life Questionnaire-C30 (EORTC QLQ-C30). Nutritional indicators and the total life condition of the two groups at different time were compared. Results There were 5 cases off in the intervention group and the control group respectively. After the 12th courses of chemotherapy, the intervention group serum albumin (ALB) and the mean serum prealbumin (PAB) were improved 4.10 and 74.14; and the control group were-0.09 and-0.08, there were significant differences between the two groups (t=3.202, 3.623, P<0.05).The total quality of life of the intervention group was 25.87 points while the control group was 35.13 points, there was significant difference between the two groups (t=3.321, P<0.05). The intervention group got the total health status was (72.28 ± 20.97) points after the intervention, and before the intervention was (56.67 ± 14.08) points. Meanwhile the total health status was statistically significant (t=7.01, P<0.05). Conclusions There is a significant nutritional improvement in colorectal cancer patients with chemotherapy after nutritional therapy leading by nurse specialist, which is worthy of application.

Clinical observation on oxaliplatin reintroduction combined with raltitrexed as second-line chemotherapy after the first-line oxaliplatin-based chemotherapy in advanced colorectal cancer patients / 中国肿瘤临床

Objective:To investigate the efficacy and toxicity of oxaliplatin reintroduction combined with raltitrexed as second-line che-motherapy after the first-line oxaliplatin-based chemotherapy in advanced colorectal cancer patients. Methods:The 48 evaluable pa-tients with advanced colorectal cancer following disease progression prior to the first-line chemotherapy were treated with oxaliplatin and raltitrexed (raltitrexed 3 mg/m2 ivgtt d1, oxaliplatin 100-130 mg/m2 ivgtt d1, q21d). All 48 patients were divided into two groups:Group A, non-oxaliplatin-based regimens as the first-line chemotherapy, 20 cases;Group B, oxaliplatin-based regimens as the first-line chemotherapy, 28 cases. Each group was evaluated every two cycles. Results:The response rates (RR) of Groups A and B were 30.0%(6/20) and 32.1%(9/28), the disease control rates (DCR) were 80.0%(16/20) and 75.0%(21/28), the median progression free survival time (mPFS) was 6.5 and 7.0 months, and the median overall survival time (mOS) was 10 and 13 months, respectively. No statistical sig-nificance was observed between the two groups in their RR, CR, mPFS, and mOS (P=0.264, 0.514, 0.713, 0.788), respectively. The most common adverse effects observed wereⅠ-Ⅱgrades of bone marrow suppression, aminotransferase abnormality, and digestive toxici-ties. The incidence of neurotoxicity (Ⅰ-Ⅱgrades) between the two groups was similar. Conclusion:Instead of irinotecan combined with raltitrexed, oxaliplatin reintroduction combined with raltitrexed for second-line chemotherapy after the first-line oxaliplatin-based chemotherapy in advanced colorectal cancer patients is feasible.

Clinical Observation of Aidi Injection Combined with Oxaliplatin and Tegafur Gimeracil Oteracil Potassium in the Treatment of Advanced Colorectal Cancer / 中国药房

OBJECTIVE:To observe the efficacy and safety of Aidi injection combined with oxaliplatin and tegafur gimeracil oteracil potassium in the treatment of advanced colorectal cancer. METHODS:100 patients with advanced colorectal cancer were ran-domly divided into control group and observation group. Control group was treated with Tegafur gimeracil oteracil potassium cap-sule,body surface area1.50 m2,60 mg,it was orally tak-en after breakfast and dinner d1-28,the drug was stopped for 14 d after 28 d treatment+oxaliplatin 85-130 mg/m2 adding into 500 ml of 5% Glucose injection by intravenous infusion for 2 h. Observation group was additionally treated with Aidi injection 100 ml add-ing into 500 ml of 5% Glucose injection by intravenous infusion,once a day,d1-7,which was repeated every 14 d and was twice. The clinical efficacy,toxicity reactions,improvement of life quality and one-year survival rates in the two groups were observed. RESULTS:There was no statistically significant difference in the total effective rate between 2 groups (P>0.05). The improve-ment rate of life quality and one-year survival rate in the observation group were significantly higher than control group,the inci-dence rates of granulocytopenia,platelet decline,oral ulcer and peripheral neurotoxicity in observation group were significantly low-er than control group, there was significant difference between 2 groups (P<0.05). CONCLUSIONS:The life qnality and one-year surviral rate of Aidi injection combined with oxaliplatin and tegafur gimeracil oteracil potassium is better than only oxalipl-atin combined with tegafur gimeracil oteracil potassium in the treatment of advanced colorectal cancer,with better safety.

Prognostic value and sensitivity to chemotherapy of microsatellite instability in advanced colorectal cancer / 中国癌症杂志

Background and purpose:Microsatellite instability (MSI) status is commonly applied to predict the prognosis and chemosensitivity in stage Ⅱ and stage Ⅲ colorectal cancer patients. However, researches of its function on metastasis colorectal cancer are limited. This study investigated its value on prognosis and chemosensitivity in metastatic colorectal cancer (CRC) patients.Methods:We retrospectively investigated tumor tissues from metastasis CRC patients who were treated with oxaliplatin and 5-FU-based therapy regimens (FOLFOX and XELOX). Immunostaining of proteins of the mismatch repair genehMLH1,hMSH2,hMSH6 andhPMS2 was performed. Prognostic value and chemosensitivity in patients with MSI status were also determined.Results:Clinical features from 113 patients were analyzed. No cor-relation of overall survival (OS) and chemosensitivity with MSI status was found. We further investigated 79 patients with synchronous metastasis and palliatively tumor resection. Median progression free survival (PFS) from 22 MSI patients was significant longer than that in 57 MSS patients (19.9 monthsvs 7 months,P=0.005). No significant difference was seen in OS comparison (P=0.07). MSI status was also an independent prognostic factors of PFS by Cox multivariate analysis (MSS/MSI,HR=2.079,P=0.043). Moreover, in this group, MSI patients had improved disease control rate (59.1%vs 31.6%, P=0.025) in chemosensitivity analysis than MSS patients.Conclusion:A better PFS in MSI patients with synchronous metastasis and palliative tumor resection was found after treated with oxaliplatin and 5-FU-based therapy and a better chemosensitivity in MSI patients was also found.

The clinical effects of single-agent Xeloda (Capecitabine) and related risk factors in treatment of patients with advanced colorectal cancer / 中国生化药物杂志

Objective To explore the clinical effects of single-agent Xeloda (Capecitabine) therapy and the related risk factors in patients with advanced colorectal cancer. Method Seventy-eight patients with advanced colorectal cancer were treated with oral Xeloda, 1250 mg/m 2 twice daily, on days 1-14 every 21 days. At least 2 cycles were administered. The short-term clinical effects were evaluated, and the related risk factors were tested by Logistic regression analysis. Results The overall response rate was 32.05%with 5 cases complete response (CR), 20 cases partial response (PR), 31 cases stable disease (SD), 22 cases progress disease (PD). The Logistic regression analysis showed that the age (OR=1.52, 95%CI 1.015~2.319), fast blood glucose (OR=1.30, 95%CI 1.483~3.677), albumin (OR=1.98, 95%CI 1.526~2.572), ALT (OR=2.37, 95%CI 1.621~3.509) and AST (OR=2.21, 95%CI 1.526~2.572) were independent risk factors for inefficient treatment. Conclusion The single-agent Xeloda (Capecitabine) is an efficacious treatment for the patients with advanced colorectal cancer. However, the inefficient rate is also high and it relates to a variety of factors. We should comprehensively evaluate the patients to improve the short-term clinical effects.

Long-term effect of pseudomonas aeruginosa preparation on advanced colorectal cancer during surgery / 中国肿瘤临床

Objective: This study aimed to observe the long-term effect of Pseudomonas aeruginosa preparation used in peritoneal injection of advanced colorectal cancer patients during surgery. Methods: A total of 83 colorectal cancer patients who received surgery between September 2006 and March 2008 were enrolled in this study. The patients were divided into two groups. Palliative resection and a 10 ml P. aeruginosa peritoneal injection were performed in 30 of 83 patients in the treatment group. Simple palliative resection was conducted in the other 53 patients, which comprised the control group. Both groups were then treated by regular chemotherapy and radiotherapy. Results:The follow-up visit was completed in 79 of 83 patients, with a high follow-up rate of 95.2%. No significant difference was found in the five-year overall survival time between the two groups (P=0.403). However, the five-year median survival time in the control group was only 13.9 ± 2.14 months, whereas that in the treatment group was 17.2 ± 2.12 months. Conclusion: Within a short period, peritoneal injection of P. aeruginosa during surgery could confer certain survival advantages for advanced colorectal cancer patients. However, the long-term effect of this therapy remains unknown.

Analysis of the Prognostic Effectiveness of a Multivisceral Resection for Locally Advanced Colorectal Cancer

PURPOSE: The aim of this study was to evaluate the prognostic effectiveness of multivisceral resections of organs involved by locally advanced colorectal cancer. METHODS: A retrospective study was performed to analyze the data collected for 266 patients who underwent a curative resection for pT3-pT4 colorectal cancer without distant metastasis from January 2000 to December 2007. Of these 266 patients, 54 patients had macroscopically direct invasion of adjacent organs and underwent a multivisceral resection. We evaluated the short-term and the long-term outcomes of a multiviceral resection relative to that of standard surgery. RESULTS: The most common location for the primary lesion was the rectum, followed by the right colon and the sigmoid colon. Among the combined resected organs, common organs were the small bowel, ovary, and bladder. In the multivisceral resection group, tumor infiltration was confirmed histologically in 44.4% of the cases while in the remaining patients, a peritumorous adhesion had mimicked tumor invasion. Postoperative complications occurred in 17.5% of the patients who underwent standard surgery vs. 35.2% of those who underwent a multivisceral resection (P < 0.0001). But the survival rate of patients after a multivisceral resection was similar to that of patients after standard surgery (5-year survival rates: 61% vs. 58%; P = 0.36). CONCLUSION: For locally advanced colorectal cancer, multivisceral resection was associated with higher postoperative morbidity, but the long-term survival after a curative resection is similar to that after a standard resection. Thus, a multivisceral resection can be recommended for most patients of locally advanced colorectal cancer.

Meta-Analysis of Clinical Efficacy and Safety about Hyperthermic Intraperitoneal Perfusion Chemotherapy in Treatment of Advanced Colorectal Cancer / 中国普外基础与临床杂志

Objective To investigate the clinical efficacy and safety of hyperthermic intraperitoneal perfusion chemotherapy (HIPC) in treatment of advanced colorectal cancer.Methods The Meta-analysis was applied to analyze 8 randomized controlled quantitative studies published at domestic and abroad.These patients treated by HIPC after radical operation with colorectal cancer were included for the treatment group,and those treated only by radical operation with colorectal cancer for the control group.Relative risk (RR) of outcome variable of 3-year and 5-year survival rate and safety between the two groups were compared.Results There were 8 selected literatures,including 1 501 cases,in which 765 cases for treatment group,and 736 cases for control group.RR of 5-year survival rate of the total patients was 2.39 (95% CI:1.66-3.45).RR of 3-year survival rate of the total patients was 2.13 (95% CI:1.45-3.13).The results demonstrated that HIPC could improve 5-year and 3-year survival rate,and sensitivity analysis confirmed the conclusions more reliable.The security was described in 5 literatures,the available information showed smaller potential security issue.Conclusions HIPC after radical operation of advanced colorectal cancer can increase 5-year and 3-year survival rate of patients,improve the prognosis of patients.Whether patients with increased incidence of postoperative complications related to the HIPC is no clear-cut conclusions for lack of related research.

Comparison in Efficacy and Safety of Three Adjuvant Chemotherapy of Stage Ⅲ Colorectal Cancer / 昆明医科大学学报

Objective TO evaluate the efficacy and safety of three adjuvant chemotherapy regimens after curative resection for stage III colorectal cancer,and present clinical evidence for proper choice.Methods 256 cases with stage Ⅲ colorectal cancer randomized to receive de Gramont,modified FOLFOX4(mFOLFOX4) and XELOX regimens.3-year disease-free survival(DFS) and overall survival(OS) were compared within the three groups and subgroups.Therapeutic adverse events were recorded and analyzed with Kaplan-Meier.Results Compared with de Gramont regimen,mFOLFOX4 and XELOX had superior efficacy.The two former could significantly improve 3-year DFS(79.7% vs.66.2%,P=0.015;81.5% vs.66.2%,P=0.004) and medium survival time(40.2 mon vs.37.8 mon,P=0.024;41.4 mon vs.37.8 mon,P=0.014).Meanwhile they could respectively decrease the ratio of recurrence risk 18%(P=0.024) and 21%(P=0.003).The relative benefit of mFOLFOX4 versus XELOX didn't differ for 3-year DFS [hazard ratio(HR): 0.84,95% confidence interval(CI): 0.79～1.12,P=0.13] and OS(HR: 0.87,95%CI: 0.84~1.06,P=0.54).In advanced analysis of DFS in subgroup,XELOX had better trend of survival advantage.mFOLFOX4 had higher adverse events within these regimens,especially in grade 3 or 4 neutropenia and peripheral neurologic adverse events.Conclusion XELOX maintains its efficacy and safety ratio in advanced colorectal cancer.Patients have good tolerance and compliance.The regiment is deserved to be applied in clinic.

Irinotecan plus fuorouracil/ leucovorin as the first-line in treatment of 37 patients with advanced colorectal cancer / 中国癌症杂志

Background and purpose:Irinotecan plus fuorouracil/Leucovorin has become the standard regimen as the first-line in treating advanced colorectal cancer.We investigated the clinical response and side-effects of the first-line treatment with Irinotecan plus fuorouracil/ leucovorin(FOLFIRI) for advanced colorectal cancer.Methods:From may 2001 to march 2005,37 patients with advanced colorectal cancer were treat with irinotecan 180mg/m~(2) i.v.on day 2,and fuorouracil 400 mg/m~(2),bolus on day 1,2 and 1200 mg/m~(2),civ.44hour;leucovorin 200 mg/m~(2) i.v.on day 1,2,two weeks per cycle.Results:The response rate was 41.7%.Incidence of III/IV Grade myelosuppression was 35.1%/8.1%,and 4 patients suffered from febrile neutropenia.Incidence of III Grade delayed diarrhea was 8.1%.Conclusions:The first-line chemotherapy with a combination of irinotecan and fuorouracil/ leucovorin is effictive and well tolerated by patients with advanced colorectal cancer.

Clinical Study on Advanced Colorectal Cancer Treated by Yiqi Huoxue TCM Combined with Chemotherapy / 中国中医药信息杂志

Objective To observe the effect of Yiqi Huoxue TCM combined with L-OHP+CF+5-FU regimen in treating advanced colorectal cancer patients. Methods 68 advanced colorectal cancer patients were randomly assigned to treatment group (38 patients, treated by Yiqi Huoxue TCM combined with L-OHP+CF+5-FU) and control group (30 patients, treated with L-OHP+CF+5-FU regimen). The therapeutic effects of two groups were observed. Result Clinical beneficial rate (CR+PR+SD) of treatment group and control group were 78.9% and 53.3% respectively (P

Meta-analysis of Oxaliplatin or Irinotecan Combined with 5-FU/LV for Advanced Colorectal Cancer / 中国药房

OBJECTIVE:To evaluate clinical efficacy and toxicities of oxaliplatin or irinotecan combined with 5-FU/LV for advanced colorectal cancer. METHODS:RCTs were retrieved from PubMed database and CHKD and Metaanalysis was carried out using Review Manager version 4.2.2 software. RESULTS:Six studies were enrolled. The oxaliplatin group was superior to irinotecan group in the overall response rate(RR=0.82,95%CI ranged from 0.74 to 0.91). The incidence rate of neutropenia in irinote-can group was lower than in oxaliplatin group(RR=0.79,95%CI ranged from 0.69 to 0.90)while the incidence of nausea/vomiting and diarrhea in irinotecan group was higher than in oxaliplatin group(RR=1.85,95%CI ranged from 1.42 to 2.40;RR=1.75, 95%CI ranged from 1.41 to 2.17). CONCLUSION:The scheme oxaliplatin combined with 5-FU/LV in the treatment of advanced colorectal cancer is superior to the scheme irinotecan combined with 5-FU/LV.

Clinical Observation of Irinotecan in Combination of Fluorouracil and Calcium Folinate as A Second Line Treatment for Advanced Colorectal Cancer / 中国药房

OBJECTIVE:To observe the clinic efficacy and safety of FOLFIRI as a second line treatment for patients with advanced colorectal cancer.METHODS:Twenty-eight patients with advanced colorectal cancer whose disease progressed after first treatment with FOLFOX4 were included to receive the second line treatment with FOLFIRI regimen.RESULTS:Of the total 28 cases,0 had complete response,6 partial response,16 stable disease,6 progressive disease,and the responsive rate was 21.4%.The majority of adverse reaction was nausea,vomiting,leucopenia and tardive diarrhea.CONCLUSION:As a second line therapy,FOLFIRI has a confirmed therapeutic response and tolerable toxicity in patients with advanced colorectal cancer.