伊立替康联合西妥昔单抗治疗老年人晚期结直肠癌临床研究  

Clinical study on irinotecan plus cetuximab in the treatment of advanced colorectal cancer in the elderly

作　　者：邱峰[1] 尹燕军[2] 胡丽丽[2] 钟文娟[2] 

机构地区：[1]华中科技大学同济医学院,武汉430030 [2]南昌大学第一附属医院肿瘤科

出　　处：《中华老年医学杂志》2013年第12期1297-1299,共3页Chinese Journal of Geriatrics

摘　　要：目的观察西妥昔单抗联合伊立替康治疗伊立替康耐药的老年人晚期结直肠癌的有效性及安全性。方法40例K—Ras野生型伊立替康耐药的老年晚期肠癌患者，随机分为西妥昔单抗单周联合伊立替康组（A组）及西妥昔单抗双周联合伊立替康组（B组）。A组中西妥昔单抗第一次治疗给药为400mg／m2，随后每周重复给药250mg／m2，B组中西妥昔单抗每次治疗给药为500mg／m2，每14d重复。伊立替康每次治疗给药180mg／m2，静滴30～90min，每14d重复。结果西妥昔单抗A组对比西妥昔单抗B组：客观有效率30．0％和25．0％（P〉0．05）；疾病控制率60．0％和55．0％（P〉0．05）；中位疾病进展时间5．8个月和5．6个月（P〉0．05）；中位总生存期为9．8个月和9．5个月（P〉0．05）。A组3级以上血液性毒性、胃肠道毒性和皮疹毒性分别为2例、2例和1例；B组3级以上血液性毒性、胃肠道毒性和皮疹毒性分别为3例、1例和2例，两组的不良反应差异无统计学意义（均P〉0．05）。结论伊立替康联合西妥昔单抗治疗伊立替康耐药的老年晚期结直肠癌患者有效，西妥昔双周用法与单周用法疗效相似但更方便。Objective To observe the efficacy and safety of cetuximab chemotherapy combined with irinotecan in the treatment of advanced colorectaI in the elderly. Methods 40 irinotecan- resistant patients with K-Ras wild type were randomized to cetuximab weekly combined with irinotecan group （group A） and cetuximab biweekly combined with irinotecan group （group B）. In group A, cetuximab was given at an initial dose of 400 mg/m2 , followed by weekly 250 mg/m2. In group B, cetuximab and irinotecan were given at 500 mg/m2 and 180 mg/m2 respectively every two weeks. Time to progression （TTP）, overall survival （OS） and toxicity were compared between the two groups. Results There were no significant differences in objective response rate （RR）, disease control rate （DOC）, TTP and OS between goup A and group B （30.0% vs. 25.0%, 60.0% vs. 55.0%, 5.8 months vs. 5.6 months, 9.8 months vs. 9.5 months, respectively, all P^0.05）. Grade 3 or more toxicities including hematological toxicity, gastrointestinal reactions and skin toxicity were found in 2 cases, 2 cases and 1 case respectively in group A and 3 cases, 1 case and 2 cases respectively in group B. The two groups had no significant differences in toxicities （all P^0.05）. Conclusions Cetuximab combined with irinotecan therapy is effective in the treatment of advanced colorectal cancer in elderly irinotecan-resistant patients. Cetuximab biweekly regimen is more convenient but has the same efficacy and toxicity as compared with cetuximab weekly regimen.

关 键 词：结直肠肿瘤 抗体 单克隆 药物疗法 

分 类 号：R735.3[医药卫生—肿瘤]