| Background and objectivesColorectal cancer (CRC) is one of the most common malignant tumors in the world. Based on the estimates from American Cancer Society in2011, about141,120new cancer cases and49,380deaths from colorectal cancer are projected to occur in the United States in2008, It’s the first one of digestive system malignancy. In our country the colorectal cancer standardized incidence and mortality rates, although lower than the world average, but the prevalence of colorectal carcinoma has increased year by year in China in the past several years, It is even higher in large cities such as Beijing and Shanghai,the colorectal cancer incidence rate has jumped to No.2or No.3.In2008the number of colorectal cancer was221,000,the number of deaths was110,000,Until now, the colorectal cancer incidence rates has been ranked the fourth, and mortality rate has been ranked the fifth in China. And studies have shown that our young patients more common than the patients with colorectal cancer in Europe and America, with a median age of onset is about10years earlier than the U.S. and Europe.The main treatment for colorectal cancer is radical surgery, but patients with stage Ⅱ～Ⅲ may reappear after surgery,Chemotherapy become the main method of treatment for advanced colorectal cancer.Oxaliplatin with5-fluorouracil is the standard regimen for colorectal cancer, but48hours continuous infusion of5-FU more adverse reactions and the impact quality of Life (QOL), capecitabine and oxaliplatin (XELOX regimen) is more convenient and effective, its efficacy is equivalent to FOLFOX regimen, but it has higher incidence of hand-foot syndrome than5-fluorouracil.S-1developed by the Japanese Dapeng Pharmaceutical Industry is approved for the treatment of colorectal cancer in2003, it’s reported that its single-agent response rate is37%. Overseas studies have been reported S-1unite Oxaliplatin has the same curative effect for metastatic colorectal cancer as XELOX regimen, but few reports in our country, for the selection of better and more convenient method of treatment, the study analyzed and compared the efficacy and toxicity between Tegafur Gimeracil Oteracil Potassium Capsule(S-1) unite oxaliplatin and capecitabine (Xeloda) unite oxaliplatin to treat advanced colorectal cancer.Materials and Methodsseventy-five advanced colorectal patients were divided into two groups: Study group (L-OHP+S-1):36patients were treated with L-OHP and S-1.Three weeks was a cycle. Control group (XELOX regimen):39patients were treated with L-OHP and capecitabine. Three weeks was a cycle. The changes of cancer focus,size, clinical symptoms, toxic and side effects were recorded and compared after2cycles. The time to progress was observed.ResultsAll patients were assessable for toxicity and response to treatment. In Study group and Control group, the remission rate were44.4%and41.0%, the disease control rate were80.5%and76.9%, the median time to progress were8.6months and8.0months. There was no significance between Study group and Control group(P>0.05).Side effects were similar in the two groups, mainly in bone marrow depression, dysfunction of liver and kidney, nausea and vomiting, diarrhea, hand-foot syndrome and stomatitis. Most of these side effects were of stage1-2.The incidence of thrombocytopenia was36.1%,in S-1group compared to15.3%in XELOX (P<0.05).Yet, more patients in XELOX group developed hand-foot syndrome than did in group S-1(35.8%vs13.8%)(P<0.05).ConclusionsS-1plus L-OHP and Capecitabine plus L-OHP are active therapeutic equivalence and well tolerated in patients with advanced colorectal cancer. For patients with advanced colorectal cancer, S-1combined with oxaliplatin is of efficacy, low toxicity, clinical application convenience and clinical value. |
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