Clinical Analysis Of Three Chemotherapy Schemes For First-line Treatment Of Advanced Colorectal Cancer

Objective:To investigate the clinical efficacy and the side effects of the chemotherapy regimens SOX (S-1+oxaliplatin), XELOX (xeloda +oxaliplatin) and FOLFOX6 (5-FU+LV+oxaliplatin) in the first-line treatment of advanced colorectal cancer. To analyze the influence of different clinical factors on prognosis.Methods:A retrospective analysis of 72 patients with advanced colorectal cancer confirmed by pathology from June 2010 to November 2013 in the Affiliated Tumor Hospital of Guangxi Medical University. All patients were divided into 3 groups according to the first-line chemotherapy regimens:SOX group (n=21), XELOX group (n=24) and FOLFOX6 group (n=27). To observe the clinical efficacy and the side effects of three groups according to the Response Evaluation Criteria In Solid Tumors (RECIST) and the World Health Organization (WHO) standard of anticancer drugs acute and subacute toxicities were graded. The progression-free survival (PFS) was observed. The primary endpoint was the PFS, whereas the secondary endpoints were response rates (RR), disease control rates (DCR) and side effects.Results:(1) Clinical efficacy:In the regimens of SOX, XELOX and FOLFOX6, the response rates were 42.86%,41.67%,37.04% respectively; the disease control rates were 76.19%,75.00%,74.07% respectively and the median progression-free survival (mPFS) period were 8.0 (95%CI 7.1～8.9),7.2 (95%CI 6.0～8.4),6.9 (95%CI 6.2～7.8) months respectively. Among the three groups RR, DCR, mPFS showed no statistical significant differences (P>0.05). (2) Toxicity:The side effects of myelosuppression, gastrointestinal reaction, abnormal liver function and peripheral neuritis had no statistical significant differences among the three groups (P>0.05). There were significance differences in the incidence of hand-foot syndrome among the three groups (P<0.05). The XELOX group was the highest incidence of hand foot syndrome (37.50%). There was no significance difference in the incidence of hand-foot syndrome between SOX group and FOLFOX6 group (P>0.05). (3) Prognostic factors:Univariate analysis showed that ECOG score, classification of cancer cells and the number of metastatic organ had significant influence on the PFS(P<0.05). Whereas age, sex showed no significant difference for PFS(P>0.05). Univariate analysis and multivariate Cox model analysis was used to explore the impact factors of prognosis. Only the number of metastatic organ was independent factor affecting the PFS of advanced colorectal cancer (P<0.05).Conclusion:These three chemotherapy regimens had definite and similar therapeutic effect as the first-line treatment of patients with advanced colorectal cancer. The side effects could be tolerated. While the regimen of S-1 combined with oxaliplatin had low toxicity, convenient application and good clinical value. In addition, only one metastatic organ was the good independent factor affecting the prognosis of advanced colorectal cancer.