Clinical study of chrono-chemotherapy with oxaliplatin, 5-fluorouracil and folinicacid for advanced gastrointestinal cancer

Objective To evaluate the efficacy and toxicity of chrono-chemotherapy with oxaliplatin(L-OHP),5-fluorouracil(5-Fu) and folinicacid(CF) for advanced gastrointestinal cancer.Methods 44 patients with advanced gastrointestinal cancer received chrono-chemotherapy: L-OHP 25 mg/(m2·d) infused from 10∶00 to 22∶00,with the highest plasma drug level at 16:00;5-Fu 600 mg/(m2·d) and CF 300 mg/(m2·d) infused from 22∶00 to 10∶00the next day,the highest plasma drug level at 4∶00,using a multichannel programmable infusion pump,which was repeated every 2～3 weeks for at least 2 cycles.Results 151 cycles of the chrono-chemotherapy were completed and median cycles of the treatment were 3.4.Among 33 patients with advanced gastric cancer,17 patients achieved partial remissions(PR),10 patients achieved stable diseases(SD) and 6 patients achieved progressive diseases(PD).Among 11 patients with advanced colorectal cancer,4 patients achieved partial remissions(PR),4 patients achieved stable diseases(SD) and 3 patients achieved progressive diseases(PD).All patients had a total response rate of 47.7%(21/44),and the median time of tumor progression(TTP) was 5 months.The median overall survival time was 8 months.The main toxicity includes myelosuppression,nausea/vomiting,end-brush neurotoxicity,mucositis and diarrhea.Most toxicities were grade Ⅰ～Ⅱ.Conclusion Chrono-chemotherapy with oxaliplatin,5-fluororuacil and folinicacid is effective and safe in the treatment of advanced gastrointestinal cancer.