K-ras基因突变型晚期大肠癌患者一线化疗及靶向治疗疗效分析  

First-line chemotherapy and targeted therapy efficacy analysis in advanced colorectal cancer patients with K-ras gene mutations

作　　者：夏学明 毛志远[1] 张婷婷[1] 苏丹[1] 王李杰[1] 白莉[1] 

机构地区：[1]解放军总医院肿瘤内一科,北京100853

出　　处：《解放军医学院学报》2014年第11期1101-1104,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨K-ras基因突变型晚期大肠癌患者一线化疗及联合靶向治疗方案的疗效。方法回顾性分析2008年1月-2013年12月本院收治的经病理确诊的55例K-ras基因突变型晚期大肠癌患者的临床及病理特征,并行疗效观察及生存分析。结果随访至2013年12月31日,55例中45例(81.8%)死亡,中位总生存期为14.4个月,中位无进展生存期为5.7个月,1年生存率为66%。在客观缓解率方面,奥沙利铂组客观缓解率(objective response rate,ORR)(32%)较伊立替康组ORR(23.1%)高,伊立替康+BEV组ORR(37.5%)较伊立替康组ORR(23.1%)高,但差异均无统计学意义;在疾病控制率方面,伊立替康+BEV组治疗疾病控制率(disease control rate,DCR)(100%)较伊立替康组DCR(84.6%)高,但亦无统计学差异。结论 K-ras突变型患者使用以奥沙利铂为主的化疗方案更有利于客观缓解率的提高;化疗联合贝伐珠单抗对于K-ras突变型患者生存期的延长显示出一定作用。Objective To explore the efficacy of first-line chemotherapy and targeted therapy in advanced colorectal cancer patients with K-ras gene mutations.Methods Clinical data about 55 advanced colorectal cancer patients with K-ras gene mutations who received therapy in our hospital from January 2008 to December 2013 were retrospectively analyzed.Results Follow-up was done till December 31,2013,of the 55 patients,45 patients （81.8％） died,the median overall survival （mOS） was 14.4 months,the median progression free survival （mPFS） was 5.7 months,and the 1-year survival rate was 66％.In terms of objective response rate,the first-line chemotherapy Oxaliplatin group had a better ORR compared with Irinotecan group （32％ vs.23.1％）,while the Irinotecan ＋ BEV group had a better ORR compared with Irinotecan group （37.5％ vs.23.1％）,but the difference was not statistically significant.In terms of disease control rate,the Irinotecan ＋ BEV group had a better DCR compared with Irinotecan group （100％ vs.84.6％） with no statistically significant difference.Conclusion Oxaliplatin-based chemotherapy is more conductive to improve objective response rate for K-ras gene mutations patients,chemotherapy combined with bevacizumab shows some effect on prolonging survival time of K-ras gene mutations patients.

关 键 词：K-RAS基因 大肠癌 化学疗法 靶向治疗 

分 类 号：R735.34[医药卫生—肿瘤]