两周一次CAPOX与三周一次CAPOX在术后CRC的辅助治疗中:一个随机对照试验
Hangyu Zhang1, Danyang Wang2, Zhou Tong1
1Department of Medical Oncology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
PloS one
|July 11, 2025
概括
与标准的三周一次疗程相比,每两周一次的化疗 (capecitabine和oxaliplatin) 显示出较少的副作用,如血小板缺血和中性质缺血. 这两种疗法在结直肠癌患者中都显示出类似的3年无病生存率.
科学领域:
- 在瘤学瘤学.
- 临床药理学 临床药理学
- 癌症研究 癌症研究
背景情况:
- 结肠直肠癌 (CRC) 是一个重大的全球健康挑战.
- 辅助化疗在改善II期和III期高风险CRC患者的治疗结果方面发挥着至关重要的作用.
- 优化化疗方案的安全性和有效性是正在进行的研究领域.
研究的目的:
- 为了比较修改两周一次的capecitabine和oxaliplatin (CAPOX) 治疗方案的安全性和疗效,与传统的三周一次的CAPOX治疗方案相比.
- 评估血小板缺血的发病率作为主要安全终点.
- 评估3年无病生存率 (DFS) 作为二级疗效终点.
主要方法:
- 一项随机对照试验,涉及高风险II期和III期手术后CRC患者.
- 患者被分配到每三周一次的CAPOX组 (oxaliplatin 130 mg/m2,capecitabine 1000 mg/m2两次1-14天) 或每两周一次的CAPOX组 (oxaliplatin 85 mg/m2,capecitabine 1000 mg/m2两次1-10天).
- 主要终点:血小板缺血的发生率. 二级终点:三年期的DFS率. 后续工作至2024年10月.
主要成果:
- 与每两周一次的CAPOX组相比,每两周一次的CAPOX组显示出所有级别的血小板缺血率 (33%对49%,P=0.02) 和中性质缺血率 (36%对51%,P=0.04) 显著较低.
- 三年DFS率是可比的:每两周一次的CAPOX为85.1%,每三周一次的CAPOX为80.4% (P=0.51).
- 在两周一次的组中,不完整治疗率较低 (7.5%对15%,P=0.13).
结论:
- 与三周一次的CAPOX相比,两周一次的CAPOX是一种更安全的治疗方案,与三周一次的CAPOX相比,血小板缺血和中性缺血的发病率降低了.
- 这两种疗法在高风险II/III期手术后CRC患者中产生相似的3年无病生存率.
- 两周一次的治疗方案可能会提供更耐受的治疗选择,而不会影响长期的疗效.
相关概念视频
01:29Drugs for Treatment of Ulcerative Colitis in IBD
239
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
239
01:21Inflammatory Bowel Disease V: Surgical Management
221
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
221
01:21Drugs for Treatment of Constipation-Predominant IBS
347
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
347
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
272
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
272
01:29Inflammatory Bowel Disease IV: Pharmacological Management
198
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
198
01:17Drugs for Treatment of Diarrhea-Predominant IBS
303
Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
303