A Retrospective Analysis Of Irinotecan Plus Fluorouracil With Oxaliplatin As First-line Treatment In Advanced Colorectal Cancer

Objective:To evaluate the efficacy and safety of irinotecan plus oxaliplatin combined with fluoropyrimidine(5-FU/S-1/capecitabine)as first-line chemotherapy in advanced colorectal cancer.Methods:A total of 35 advanced colorectal cancer patients with at least one measurable lesion were enrolled from March 2013 to October 2014.Patients received once every 2 weeks,irinotecan 130?160mg/m2,day l;plus oxaliplatin 85?100mg/m2,day 2;and fluorouracil 400mg/m2,day 1,then 2400mg/m2 continuous infusion 46 hours,leucovorin 200mg/m2,after 5-Fu;The fluorouracil could be replaced by S-1(according to the body surface area):body surface area<1.25m2,40mg twice a day;1.25?1.5m2,50mg twice a day;>1.5m2,60mg twice a day;or capecitabine 1000mg/m2 twice a day on days 1 to 10.The efficacy and adverse events were assessed every 6 weeks until progression and every 3 months thereafter until death.Results:Of 35 evaluable patients,the median chemotherapy cycles was 4(3-11).The objective response rate(ORR)was 54.3%(19/35).Complete response(CR)was observed in one case,with a partial response(PR)in 18 cases.25 patients underwent surgery after chemotherapy,and 20 patients achieved R0 resection(57.1%,20/35),including 18 of locally advanced disease and two of matastatic disease.The median progression-free survival was 23.9 months[95%CI(10.2,37.7)].And the median survival was 30.7 months.Among the 35 patients,the rate of grade 3adverse event was 54.3%(19/35),including 20.0%of neutropenia(7/35),17.1%of nausea(6/35),14.3%of vomiting(5/35)and 40.0%of diarrhea(14/35).The rate of grade 4 adverse event was 17.1%(6/35),most of which was neutropenia.No patients died due to treatment related adverse events.Conclusion:The modulated three-drug combined regimen as first-line treatment in advanced colorectal cancer had promising efficacy and was well-tolerated,which may be regarded as one of the preferred options.