A Randomized Controlled Trial Of CAPRINOX Or FOLFOXIRI In The Treatment Of Locally Advanced Or Metastatic Colorectal Cancer

Objective:To analyze the efficacy and safety of the capecitabine,irinotecan,and oxaliplatin(CAPIRINOX)and 5-fluorouracil/leucovorin,irinotecan,and oxaliplatin(FOLFOXIRI)regimens as first-line therapy for locally advanced or metastatic colorectal cancer.Methods:A total of 58 patients with locally advanced or metastatic colorectal cancer received first-line chemotherapy.36 patients were administered CAPIRINOX,and the remaining 22 patients were administered FOLFOXIRI.The clinical outcomes and safety profiles were evaluated according to the objective response rate(ORR),median progression-free survival,RO resection rate and adverse effects.Result:The ORR,DCR,median progression-free survival(mPFS),R0 resection rate,changes of CEA and CA199 in the CAPIRINOX group were not statistically different from those in the FOLFOXIRI group(69.4%vs 59.1%,94.4%vs 86.4%,10months vs 9 months;22.2%vs 22.7%;P>0.05).However,there was a difference in the length of stay between the two groups(P=0.007<0.05),and the length of stay in the observation group was shorter.No treatment-related deaths occurred.The major adverse events were neutropenia,thrombocytopenia,fatigue,nausea/vomiting,diarrhea,neurotoxicity,alopecia,hand-foot syndrome,and mucositis.Nausea/vomiting were statistically significat in the two groups(P<0.05),the control group was more obvious.The total rate of grade 3/4 adverse events in the CAPRINOX group was 27.8%(10/36),while the total rate of grade 3/4 adverse events in the FOLFOXIRI group was 36.4%(8/22).Toxicities between the two groups were not statistically significant(P=0.493).Conclusion:Both the CAPIRINOX and FOLFOXIRI regimens are effective as first-line treatment for locally advanced or metastatic colorectal cancer.Toxicities between the two groups were not statistically significant,except for nausea/vomiting,which was higher in the FOLFOXIRI regimen.The CAPRINOX program can avoid carrying infusion pumps,reduce the risk of central venous catheterization,and reduce frequent hospital visits.Therefore,it is safer and more reliable,and it is worthy of further promotion and application.