K—ras基因型与转移性结直肠癌患者的疗效及预后的关系  

Analysis of therapeutic effect and prognosis in patients with metastatic colorectal cancer and differentK-ras status

作　　者：葛飞娇[1] 刘建芝[1] 李珊珊[1] 王岩[1] 刘烈军[1] 姚凯[1] 赵传华[1] 付亚莉[1] 林莉[1] 徐建明[1] 

机构地区：[1]军事医学科学院附属医院消化肿瘤内科,北京100071

出　　处：《中华肿瘤杂志》2013年第4期273-276,共4页Chinese Journal of Oncology

摘　　要：目的分析转移性结直肠癌患者的K—ras基因型与临床疗效和患者预后的关系。方法回顾性分析153例不同K—ras基因型的转移性结直肠癌患者的临床特征、治疗方案和生存情况。结果K—ras野生型患者的中位总生存时间（0s）为31．7个月，高于突变型患者（21．3个月，P=0．037）。K—ras野生型患者中，抗表皮生长因子受体（EGFR）单抗联合化疗组的有效率高于单纯化疗组（P〈0．05）；抗EGFR单抗联合化疗组的无进展生存时间（PFS，9．6个月）高于单纯化疗组（6．6个月，P=0．036）。接受抗EGFR单抗联合伊立替康为主的二线化疗的患者的有效率和PFS均高于单纯化疗组（P=0．003和P=0．019）。抗EGFR单抗联合化疗序贯治疗组患者的中位PFS为11．5个月，高于同时治疗组（5．2个月，P=0．02）；序贯治疗组患者的中位0s为39．3个月，高于同时治疗组（31．7个月，P=0．034）。结论在转移性结直肠癌中，K—ras基因野生型患者的预后可能优于突变型。采用抗EGFR单抗联合化疗的序贯模式治疗，可以明显改善K—ras野生型患者的生存状况。Objective To evaluate the correlation of clinical effect and prognosis between patients with metastatic colorectal cancer （mCRC） and different K-ras status. Methods The clinical characteristics, chemotherapeutic regimens and survival of 153 mCRC patients with different K-ras status were analyzed retrospectively. Results The median overall survival （OS） in patients without K-ras mutation were 31.7 months, significantly longer than 21.3 months in the patients with K-ras mutation （P = O. 037）. The median progression-free survival （PFS） and OS in patients who received chemotherapy followed by anti-EGFR antibody treatment were 11.5 and 39.3 months, respectively, significantly longer as compared with the PFS and OS in those received chemotherapy in combination with anti-EGFR antibody concomitantly （5.7, P=0.02, and28.7 months, P=0.034, respectively）. Conclusions K-ras status is a prognostic biomarker for mCRC patients treated with anti-EGFR antibody. The combination settings of antiEGFR in combination with chemothera!av may improve survival of mCRC patients with wild-type K-ras status.

关 键 词：结直肠肿瘤 K-RAS基因 受体 表皮生长因子 靶向治疗 

分 类 号：R735[医药卫生—肿瘤]