Objective To compare and evaluate the effectiveness and safety of irinotecan (IRI) versus oxaplatin (OXA), in combination with 5-FU/LV for patients with advanced colorectal cancer.
Methods The literature search, study selection and assessment, data collection and analysis were undertaken by two reviewers according to the Cochrane Handbook for Systematic Reviews of Interventions. Randomised controlled trials (RCTs) or quasi-RCTs comparing IRI versus OXA, in combination with 5-FU/LV in the treatment of advanced colorectal cancer were collected.
Results Seven studies involving 2107 patients were included. The OXA/5-FU/LV regimen was superior or at least equal to the IRI/5-FU/LV regimen in prolonging overall survival and time to progression. The OXA/5-FU/LV regimen showed a higher response rate and was associated with lower toxicities.
Conclusion Compared with IRI, OXA is more appropriate for the treatment of advanced colorectal cancer when combined with 5-FU/LV.
Citation：
WANG Ting,LUO Lili,ZHOU Qinghua,WU Taixiang. Irinotecan versus Oxaplatin in Combination with 5-FU/LV for \Advanced Colorectal Cancer: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2008, 08(1): 36-41. doi: 10.7507/1672-2531.20080009
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- 1. Colucci G, Gebbia V, Paoletti G, et al. Phase III Randomized Trial of FOLFIRI Versus FOLFOX4 in the Treatment of Advanced Colorectal Cancer: A Multicenter Study of the Gruppo Oncologico Dell’Italia Meridionale. J Clin Oncol, 2005, 23(22): 4811-4814.
- 2. Comella P, Massidda B, Filippelli G, et al. Oxaliplatin plus high-dose folinic acid and 5-fluorouracil i.v. bolus (OXAFAFU) versus irinotecan plus high-dose folinic acid and 5-fluorouracil i.v. bolus (IRIFAFU) in patients with metastatic colorectal carcinoma: a Southern Italy Cooperative Oncology Group phase III trial. Ann Oncol, 2005, 16(6): 845-846.
- 3. Delaunoit T, Goldberg RM, Sargent DJ. Mortality associated with daily bolus 5-fluorouracil/leucovorin administered in combination with either irinotecan or oxaliplatin: results from Intergroup Trial N9741. Cancer, 2004, 101(10): 2170-2176.
- 4. Goldberg RM, Sargent DJ, Morton RF, et al. A Randomized Controlled Trial of Fluorouracil Plus Leucovorin, Irinotecan, and Oxaliplatin Combinations in Patients With Previously Untreated Metastatic Colorectal Cancer. J Clin Oncol, 2004, 22(1): 4-6.
- 5. Goldberg RM, Sargent DJ, Morton RF, et al. Randomized Controlled Trial of Reduced-Dose Bolus Fluorouracil Plus Leucovorin and Irinorecan or Infused Fluorouracil Plus Leucovorin and Oxaliplatin in Patients With Previously Untreated Metastatic Colorectal Cancer: A North American Intergroup Trial. J Clin Oncol, 2006, 24(21): 3347-3353.
- 6. Kalofonos HP, Aravantinos G, Kosmidis P, et al. Irinotecan or oxaliplatin combined with leucovorin and 5-fluorouracil as first-line treatment in advanced colorectal cancer: a multicenter, randomized, phase II study. Annals of Oncology, 2005, 16: 869-877.
- 7. Tournigand C, André T, Achille E, et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol, 2004, 22(2): 229-237.
