8月2日，《腫瘤學(xué)年鑒》（Annals of Oncology）發(fā)表的一項(xiàng)新研究顯示,，對于結(jié)直腸癌患者,，隨著時間的推移，奧沙利鉑聯(lián)合卡培他濱（XELOX）方案比奧沙利鉑聯(lián)合5-氟尿嘧啶和亞葉酸鈣（FOLFOX-4）方案的神經(jīng)毒性可能要低,。
研究者指出目前很少人了解FOLFOX-4和XELOX方案的相對神經(jīng)毒性如何,。這項(xiàng)前瞻性國際化多中心研究結(jié)果顯示，F(xiàn)OLFOX-4和XELOX方案治療結(jié)直腸癌患者造成的急性神經(jīng)毒性情況是一樣的,。但是,，XELOX方案可能是更好的方案，可以避免FOLFOX-4方案造成的累積神經(jīng)毒性,。
該研究前瞻性隨訪了150名患者,，規(guī)定接受FOLFOX-4或XELOX方案的治療。在基線水平,、治療后3個月和6個月進(jìn)行評估,。
兩組病人在奧沙利鉑造成的急性神經(jīng)毒性發(fā)生率和嚴(yán)重程度上相似：FOLFOX-4為84.4%，XELOX為79.5%,。然而,，F(xiàn)OLFOX-4組的慢性神經(jīng)毒性發(fā)生率明顯高于XELOX組（83.1% vs. 60.3%, p=0.002）。研究人員推測,，這種差異可能與FOLFOX-4方案中奧沙利鉑更頻繁的暴露有關(guān),。
從該研究似乎可以得出結(jié)論，當(dāng)需要避免神經(jīng)毒性時,，XELOX可能是更好的選擇方案,，研究小組認(rèn)為，還需要更多的研究去證實(shí)那種方案更為安全,。（生物谷Bioon.com）
doi: 10.1093/annonc/mds208
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Peripheral neurotoxicity of oxaliplatin in combination with 5-fluorouracil (FOLFOX) or capecitabine (XELOX): a prospective evaluation of 150 colorectal cancer patients
A. A. Argyriou1,2, R. Velasco9, C. Briani3, G. Cavaletti4, J. Bruna9, P. Alberti4, M. Cacciavillani5, S. Lonardi6, C. Santos7, D. Cortinovis8, M. Cazzaniga8 and H. P. Kalofonos9,*
Background To report our prospective experience on the incidence and pattern of oxaliplatin (OXA)-induced peripheral neuropathy (OXA-IPN) in patients with colorectal cancer (CRC) treated with either FOLFOX-4 or XELoda + OXaliplatin (XELOX).
Patients and methods One hundred and fifty patients scheduled to be treated with either FOLFOX or XELOX for CRC were prospectively monitored at baseline and followed-up during chemotherapy. The incidence and severity of symptoms secondary to OXA-IPN were recorded using three different types of assessment, i.e. the motor and neurosensory National Cancer Institute common toxicity criteria, version 3.0 (NCI-CTCv3), the clinical version of the total neuropathy score (TNSc) and electrophysiological scores.
Results Patients treated with either FOLFOX-4 or XELOX manifested similar incidence rates and severities of acute OXA-IPN. However, FOLFOX-4 was associated with increased incidence of chronic neurotoxicity, compared with XELOX-treated patients (n = 64/77 versus 44/73; P = 0.002), at a very similar OXA median cumulative dose during both regimens. Both the NCI-CTCv3 and TNSc demonstrated that the severity of cumulative OXA-IPN in FOLFOX-4-treated patients is higher than in those treated with XELOX.
Conclusion The incidence of acute neurotoxicity during FOLFOX-4 therapy is similar to XELOX. However, it seems that FOLFOX-4 is more neurotoxic than XELOX in terms of cumulative OXA-IPN, despite comparable OXA cumulative dose.
