The Influence Of Maintenance Therapy With Capecitabine For The Duration Of Diseases Control Of Metastatic Colorectal Cancer

Objective:Taking Chinese metastatic colorectal cancer patients who werenon-progression to the first-line combination chemotherapy based on5-Fu(FOLFOX/FOLFIRI regimen6-9cycles or XELOX regimen4-6cycles) as the researchobjects,The aim of this study is to comparing the difference of duration of diseasescontrol(DDC) and adverse reaction between maintenance therapy and continuouschemotherapy.Methods: Collecting47cases of patients with metastatic colorectal cancer confirmedby pathology who were diagnosed and treated at Fujian Union Hospital and FujianCancer Hospital from November2009to April2012, these cases werenon-progression to the first-line combination chemotherapy(FOLFOX/FOLFIRIregimen6-9cycles or XELOX regimen4-6cycles).According to the meaning ofpatients, they could choose the original regimen to continue chemotherapy (continuousgroup, n=24) or choose maintenance therapy with capecitabine (maintenancegroup, n=23).Result: The median DDC of maintenance group was8.93months, the median DDCof continuous group was8.50months (P=0.908),with no statistically significantdifference. Maintenance group were significantly reduction compared withcontinuous group of neutropenia (6vs.15,26.1%vs.62.5%, P=0.012) and allergicreactions of oxaliplatin (0vs.4,0%vs.16.7%, P=0.041).Drug-related grade3–4toxicity were matched between the two groups: neutropenia (4.35%vs.8.30%，P=0.576),vomiting(8.70%vs.4.17%，P=0.525),thrombocytopenia（0%vs.4.17%，P=1.0).But apart from hand–food syndrome(4.35%vs.0%), other major drug-relatedgrade1–2toxicities in maintenance group were less than the continuousgroup:neutropenia(5vs.13,21.8%vs.54.2%, P=0.022), allergic reactions ofoxaliplatin(0vs.4,0%vs.16.7%, P=0.041), anemia(0vs.3,0%vs.12.5%, P=0.08), thrombocytopenia（0vs.2，0%vs.8.3%，P=0.491）, hepatic functional impairment（5vs.8，21.7%vs.33.4%，P=0.374, neurosensory（0vs.1,0%vs.4.17%，P=1.0）.Conclusions: Chinese metastatic colorectal cancer patients who were non-progressionto the first-line combination chemotherapy(FOLFOX/FOLFIRI regimen6-9cycles orXELOX regimen4-6cycles) stopped combination chemotherapy and receivedmaintenance therapy with capecitabine,and its DDC is equivalent to continuouschemotherapy,but toxicity reaction were significantly smaller. In this study with smallcases, non randomized controlled, so further prospective randomized control trial iswarranted.