Efficacy And Safety Of XELOX And FOLFOX In The Treatment Of Advanced Colorectal Cancer

Objective: To compare the efficacy and safety of XELOX and FOLFOX in the first-line treatment of advanced colorectal cancer in different locations,and to observe the impact on the quality of life and related tumor markers.Methods: From January 2010 to June 2019,90 cases of advanced colorectal cancer were analyzed retrospectively.45 cases were treated with capecitabine combined with oxaliplatin(XELOX group),including 14 cases in the right colon,16 cases in the left colon and 15 cases in the rectum;45 cases were treated with 5-fluorouracil / calcium folinate combined with oxaliplatin(FOLFOX group),including 13 cases in the right colon,15 cases in the left colon and 17 cases in the rectum.Each patient completed at least 2 cycles of chemotherapy.According to recist1.1,the evaluation standard of solid tumor curative effect,and ctcae4.0,the difference of curative effect and drug toxicity between the two schemes in different parts(left half colon,right half colon,rectum)of advanced colorectal cancer were compared,and the quality of life and swelling of patients were observed The influence of tumor markers CA19-9 and CEA.Results: In the patients with right hemicolon,12 cases of complete compliance,2 cases of partial compliance and 0 cases of non-compliance in XELOX group,10 cases of complete compliance,3 cases of partial compliance and 0 cases of non-compliance in FOLFOX group,the compliance rate in both groups was 100%;in the patients with left hemicolon,12 cases of complete compliance,4 cases of partial compliance and 0 cases of non-compliance in XELOX group,14 cases of complete compliance and 1 case of partial compliance in FOLFOX group,The compliance rate of the two groups was 100%;Among the patients in rectum,there were 14 cases of complete compliance,1 case of partial compliance and 0 case of non-compliance in XELOX group,16 cases of complete compliance,1 case of partial compliance and 0 case of non-compliance in FOLFOX group.The compliance rate of both groups was 100%.The efficacy analysis of the two groups showed that the ORR of advanced colorectal cancer in the right hemicolon was 7.14% and0%,the DCR was 78.57% and 76.92%,,median progression free survival time were 7.5months and 6.7 months,respectively,The median overall survival time was 13.55 months and 12.5 months;and the orr of advanced colorectal cancer in the left hemicolon ORR was6.25% and 20%,DCR was 75% and 80%,and the median progression free survival time was 7.6 months and 7.1 months,respectively,The median overall survival time was 12.9months and 12.95 months,respectively.The ORR of advanced colorectal cancer with rectal location was 6.67% and 5.88%,the DCR was 73.33% and 82.35%,the median progression free survival time was 7.1 months and 7.1 months,and the median total survival time was12.5 months and 12 months,respectively.There was no statistical difference between the two groups(P > 0.05).The side effects of chemotherapy in the two groups included leucopenia,neutropenia,nausea,vomiting,peripheral neurotoxicity,hepatorenal dysfunction and hand foot syndrome.Among the patients with right hemicolon,7(50%)and 2(15.38%)cases of leukopenia,10(71.43%)and 4(30.77%)cases of neutropenia,11(78.57%)and 6(46.15%)cases of nausea,7(50%)and 4(30.77%)cases of vomiting,and 7(50%)cases of peripheral neurotoxicity,respectively)There was no significant difference between the two groups(P > 0.05).In patients with left hemicolon,leukopenia occurred in XELOX group and FOLFOX group in 7 cases,respectively 43.75% and 2(13.34%),neutropenia in 10(62.5%)and 3(20%),nausea in 10(62.5%)and 3(20%),vomiting in 8(50%)and 2(13.33%),peripheral neurotoxicity in 5(31.25%)and 2(13.33%),liver dysfunction in 2(12.5%)and 0(0%),renal dysfunction in 0(0% and 1 case(6.67%),HFS and HFS were 1case(6.25%)and 0 case(0%),respectively,except that the incidence of neutropenia and nausea in XELOX group was higher than that in FOLFOX group(P = 0.029,There was no significant difference between the other two groups(P > 0.05).In patients with rectal cancer,leucopenia occurred in 4 cases(26.67%)and 2 cases(11.76%)in XELOX group and FOLFOX group,neutropenia in 5 cases(33.33%)and 4 cases(23.53%),nausea in 9 cases(60%)and 7 cases(41.18%),vomiting in 5 cases(33.34%)and 5 cases(2.76%)respectively9.41%,peripheral neurotoxicity in 3 cases(20%)and 2 cases(11.76%),liver function abnormality in 2 cases(13.33%)and 1 case(5.88%),renal function abnormality in 1 case(6.67%)and 1 case(5.88%),hand foot syndrome in 1 case(6.67%)and 0 case(0%)respectively.There was no statistical difference between the two groups(P > 0.05).The results showed that the quality of life in patients with right and left colon cancer was significantly improved by XELOX chemotherapy(P = 0.002,0.006)and FOLFOX chemotherapy(P = 0.020)in patients with rectum cancer.After chemotherapy,the quality of life in patients with right colon cancer in XELOX group was significantly better than that in FOLFOX group.In terms of the influence of tumor marker changes,there was no statistical difference in CA19-9 and CEA values before and after chemotherapy with XELOX regimen in patients with rectal cancer,and CA19-9 and CEA values in patients with different chemotherapy regimens in other parts were significantly decreased after chemotherapy with different chemotherapy regimens,which was statistically significant.In addition,FOLFOX regimen in patients with rectal cancer was better than XELOX regimen in patients with rectal cancer CA19-9 and CEA decreased significantly in the other two groups.There was no significant difference in the degree of CA19-9 and CEA decrease in the other two groups.Conclusion: There was no significant difference between XELOX regimen and FOLFOX regimen in the first-line treatment of advanced colorectal cancer in different locations.During the course of chemotherapy,the common side effects were leucopenia,neutropenia,nausea,vomiting,peripheral neurotoxicity,liver and kidney dysfunction,and hand foot syndrome.Most of them were mild to moderate.Except the incidence of neutropenia and nausea in XELOX group was higher than that in FOLFOX group,there was no significant difference between the other two groups.In terms of improving the quality of life of patients,XELOX chemotherapy can significantly improve the quality of life of patients with the right and left colon and FOLFOX chemotherapy can significantly improve the quality of life of patients with the right colon.After chemotherapy,the quality of life of patients with the right colon in XELOX group is significantly better than that in FOLFOX group.CA19-9 and CEA decreased significantly in patients with right colon and left colon,but there was no significant difference between the two groups.CA19-9 and CEA decreased significantly in patients with rectum and FOLFOX.