结直肠癌中国改良三药FOLFOXIRI方案临床应用专家共识(2026版)OA

Chemotherapy is the cornerstone of colorectal cancer treatment,especially for microsatellite-stability/mismatch-re-pair-proficient(MSS/pMMR)colorectal cancer.The FOLFOXIRI triplet regimen[5-fluorouracil(5-FU)/leucovorin,oxal-iplatin,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 Chi-nese 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 pre-vious research data,they formulated the Chinese expert consensus on the clinical application of the Chinese modified trip-let 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 FOLFOX-IRI(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 cm-FOLFOXIRI triplet regimen will be applied in more clinical scenarios.Accordingly,the Colorectal Cancer Committee of the China South-west 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 recom-mendations 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.