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化疗是治疗结直肠癌的基石，尤其对于微卫星稳定/错配修复完整（microsatellite-stability/mismatch-repair-proficient,MSS/pMMR）的结直肠癌。FOLFOXIRI三药方案[5-氟尿嘧啶（5-fluorouracil, 5-FU）/亚叶酸钙、奥沙利铂和伊立替康]是治疗结直肠癌的高强度化疗方案，具有疗效显著但毒性较大等特点。2021年，为了推动我国临床工作者对FOLFOXIRI方案的规范化和合理化应用，由中国南方肿瘤临床研究协会结直肠癌专业委员会牵头，组织相关领域的专家，在基于中国人群特点、3种化疗药物的作用机制和既往研究数据的基础上，制定了《结直肠癌改良三药cmFOLFOXIRI方案临床应用中国专家共识》，首次提出中国改良版FOLFOXIRI方案（cmFOLFOXIRI）的剂量用法和相关不良反应的管理，使改良三药cmFOLFOXIRI方案的治疗策略得到广泛认可与推广应用。首版共识发布5年来，多项关键研究结果持续更新，全球范围内也开展了多项以FOLFOXIRI方案为基础的新临床试验，且结直肠癌患者群体日趋年轻化，改良三药cmFOLFOXIRI方案将会在更多的临床场景中应用。为此，中国南方肿瘤临床研究协会结直肠癌专业委员会再次牵头，对2021版《结直肠癌改良三药cmFOLFOXIRI方案临床应用中国专家共识》进行了更新。2026版重点更新其在晚期一线姑息治疗、转化治疗和新辅助治疗领域的临床应用证据数据，新增采用卡培他滨替代5-FU组成三药方案的专家建议和三药方案在挽救性治疗中的最新进展，同时补充更多关于cmFOLFOXIRI方案耐受性和不良反应管理方面的信息，使cmFOLFOXIRI方案疗效与安全性的循证依据更加充实，从而进一步推动该方案更加规范化、精准化与个体化的临床应用。
Abstract：Chemotherapy is the cornerstone of colorectal cancer treatment,especially for microsatellite-stability/mismatch-repair-proficient(MSS/pMMR) colorectal cancer.The FOLFOXIRI triplet regimen [5-fluorouracil(5-FU)/leucovorin,oxaliplatin,and irinotecan] is an intensive chemotherapy regimen for colorectal cancer,characterized by remarkable efficacy but relatively high toxicity.In 2021,to promote the standardized and rational clinical use of the FOLFOXIRI regimen among Chinese clinicians,the Colorectal Cancer Committee of the China Southwest Oncology Group led a panel of experts in relevant fields.Based on the characteristics of the Chinese population,the mechanisms of the three chemotherapeutic agents,and previous research data,they formulated the Chinese expert consensus on the clinical application of the Chinese modified triplet combination with irinotecan,oxaliplatin and continuous infusional 5-fluorouracil/leucovorin for colorectal cancer.This consensus proposed for the first time the dosage,administration,and adverse event management of the Chinese-modified FOLFOXIRI(cmFOLFOXIRI) regimen,leading to its wide recognition and clinical implementation.Over the five years since the initial consensus was published,multiple key studies have been updated,and numerous new clinical trials based on the FOLFOXIRI regimen have been conducted globally.Meanwhile,the population of patients with colorectal cancer has become increasingly younger,indicating that the cmFOLFOXIRI triplet regimen will be applied in more clinical scenarios.Accordingly,the Colorectal Cancer Committee of the China Southwest Oncology Group has led an update of the 2021 edition of the Chinese expert consensus on the clinical application of the Chinese modified triplet combination with irinotecan,oxaliplatin and continuous infusional 5-fluorouracil/leucovorin for colorectal cancer.The 2026 edition highlights updated evidence for first-line palliative therapy,conversion therapy,and neoadjuvant therapy,adds expert recommendations on using capecitabine to replace 5-FU in the triplet regimen and recent advances in the use of the triplet regimen for salvage therapy,and provides further information on the tolerability and adverse event management of cmFOLFOXIRI.These updates strengthen the evidence base for the efficacy and safety of the cmFOLFOXIRI regimen and further promote its standardized,precise,and personalized clinical application.
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基本信息:
DOI：10.13267/j.cnki.syzlzz.2026.029
引用信息:
[1]中国南方肿瘤临床研究协会结直肠癌专业委员会.结直肠癌中国改良三药FOLFOXIRI方案临床应用专家共识（2026版）[J],2026,41(3):199-210.DOI:10.13267/j.cnki.syzlzz.2026.029.
基金信息:
国家杰出青年科学基金（82425045）