J Clin Oncol:高危型肠癌采用奥沙利铂治疗是否可缩短至3个月以减轻神经毒性?

2021-01-19 MedSci原创 MedSci原创

由于奥沙利铂(oxaliplatin)会导致累积的神经毒性,因此,在不降低疗效的情况下,缩短治疗时间将使患者和医疗工作者受益。

由于奥沙利铂(oxaliplatin)会导致累积的神经毒性,因此,在不降低疗效的情况下,缩短治疗时间将使患者和医疗工作者受益。

本研究对来自四项研究的高危型II期结直肠癌患者数据进行汇总分析,以明确辅助双线化疗的最佳持续时间。纳入分析的患者接受氟尿嘧啶、亚叶酸和奥沙利铂(FOLFOX)或卡培他滨和奥沙利铂(CAPOX)治疗,并随机分至3月或6月治疗组。主要终点是无病存活期(DFS)和3月组相比6月组的疗效非劣效性。

共3273位患者随机分至3月组或6月组,其中62%的患者接受CAPOX治疗、38%的患者接受FOLFOX治疗。

总人群3月组 vs 6月组的预后

共553例DFS事件。3月组和6月组的5年DFS率分别为80.7%和83.9%(HR 1.17,80% CI 1.05-1.31,p=0.39)。该结果超过了非劣效性界限1.2。

不同方案治疗的3月组 vs 6月组的预后

在IDEA III期分析中,治疗持续时间的疗效似乎取决于化疗方案,尽管相互作用测试为阴性。采用CAPOX治疗的患者,3月组 vs 6月组的HR为1.02(80% CI 0.88-1.17),FOLFOX治疗的HR为1.41(80% CI 1.18-1,68)

总而言之,虽然在总人口中未能证明治疗3个月非劣效于6个月,CAPOX辅助治疗3个月的便利性、降低的毒性和成本提示,如果以奥沙利铂为基础的化疗方案合适,3月CAPOX疗法可作为高危型II期结肠癌患者的潜在选择。

原始出处:

Timothy J. Iveson, et al. Duration of Adjuvant Doublet Chemotherapy (3 or 6 months) in Patients With High-Risk Stage II Colorectal Cancer. Journal of Clinical Oncology. January 13, 2021

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    2021-08-18 minlingfeng
  3. [GetPortalCommentsPageByObjectIdResponse(id=1737673, encodeId=74ea1e376733b, content=<a href='/topic/show?id=292f965e5b5' target=_blank style='color:#2F92EE;'>#铂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96575, encryptionId=292f965e5b5, topicName=铂)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ca4034296500, createdName=ms3153534357578991, createdTime=Wed Jul 28 10:48:04 CST 2021, time=2021-07-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1865979, encodeId=445d18659e997, content=<a href='/topic/show?id=16ce133504e' target=_blank style='color:#2F92EE;'>#Oncol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13350, encryptionId=16ce133504e, topicName=Oncol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b63894, createdName=minlingfeng, createdTime=Wed Aug 18 18:48:04 CST 2021, time=2021-08-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1484119, encodeId=d54c1484119b0, content=<a href='/topic/show?id=81c2e4343a9' target=_blank style='color:#2F92EE;'>#神经毒性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=74343, encryptionId=81c2e4343a9, topicName=神经毒性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=42127951174, createdName=12498cf9m37(暂无昵称), createdTime=Thu Jan 21 07:48:04 CST 2021, time=2021-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1038181, encodeId=e999103818177, content=谢谢梅斯分享这么多精彩信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=anti-cancer, createdTime=Tue Jan 19 19:48:04 CST 2021, time=2021-01-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=918112, encodeId=9eea918112a8, content=!, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=01e35454158, createdName=李吉里吉里, createdTime=Tue Jan 19 16:58:30 CST 2021, time=2021-01-19, status=1, ipAttribution=)]
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    2021-01-19 anti-cancer

    谢谢梅斯分享这么多精彩信息

    0

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    2021-01-19 李吉里吉里

    0

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