8月2日，《肿瘤学年鉴》（Annals of Oncology）发表的一项新研究显示，对于结直肠癌患者，随着时间的推移，奥沙利铂联合卡培他滨（XELOX）方案比奥沙利铂联合5-氟尿嘧啶和亚叶酸钙（FOLFOX-4）方案的神经毒性可能要低。
研究者指出目前很少人了解FOLFOX-4和XELOX方案的相对神经毒性如何。这项前瞻性国际化多中心研究结果显示，FOLFOX-4和XELOX方案治疗结直肠癌患者造成的急性神经毒性情况是一样的。但是，XELOX方案可能是更好的方案，可以避免FOLFOX-4方案造成的累积神经毒性。
该研究前瞻性随访了150名患者，规定接受FOLFOX-4或XELOX方案的治疗。在基线水平、治疗后3个月和6个月进行评估。
两组病人在奥沙利铂造成的急性神经毒性发生率和严重程度上相似：FOLFOX-4为84.4%，XELOX为79.5%。然而，FOLFOX-4组的慢性神经毒性发生率明显高于XELOX组（83.1% vs. 60.3%, p=0.002）。研究人员推测，这种差异可能与FOLFOX-4方案中奥沙利铂更频繁的暴露有关。
从该研究似乎可以得出结论，当需要避免神经毒性时，XELOX可能是更好的选择方案，研究小组认为，还需要更多的研究去证实那种方案更为安全。（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.
