西妥昔单抗联合化疗-线治疗K-RAS野生型晚期结直肠癌疗效观察  

Efficacy observation of cetuximab combined with chemotherapy for patients with K-RAS wild-type advanced colorectal cancer

作　　者：李娟[1] 张婷婷[1] 王以尚[1] 韩春[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》2015年第6期590-594,共5页Academic Journal of Chinese PLA Medical School

摘　　要：目的观察西妥昔单抗联合化疗一线治疗K-RAS野生型晚期结直肠癌的临床疗效及安全性。方法回顾性分析2008年2月-2014年7月我院收治的98例经病理学证实的K-RAS基因野生型晚期结直肠癌患者的临床资料,其中44例应用西妥昔单抗联合奥沙利铂+亚叶酸钙+氟尿嘧啶(FOLFOx)或奥沙利铂+卡培他滨(xFLOx)方案,54例应用西妥昔单抗联合伊立替康+亚叶酸钙+氟尿嘧啶(FOLFIRI)方案治疗。每例至少接受2个周期以上化疗,每6周进行疗效评价,按照实体瘤客观疗效评价标准1.1版评价疗效。结果98例均可进行疗效评价。其中西妥昔单抗联合奥沙利铂组完全缓解(complete response,CR)2.27%,部分缓解(partial response,PR)63.64%、病情稳定(stable disease,SD)25%、病情进展(progression disease,PD)9.09%;西妥昔单抗联合FOLFIRI组CR O、PR 40.74%、SD 44.45%、PD 14.81%;两组客观缓解率(objective response rate,ORR)(65.91%vs 40.74%,P=0.013)差异有统计学意义,疾病控制率(disease control rate,DCR)(90.91%vs85.19%,P=0.390)及中位无进展生存期(progression-free survival,PFS)(8.4个月vs 7.7个月,P=0.580)差异无统计学意义。结论西妥昔单抗联合以奥沙利铂为基础的化疗方案一线治疗K-RAS野生型晚期结直肠癌患者,其疗效不劣于西妥昔单抗联合FOLFIRI方案。两组不良反应无明显差异,值得临床推广。Objective To investigate the efficacy and safety of cetuximab with FOLFIRI or FOLFOX/XELOX as first-line chemotherapy for patients with K-RAS wild-type advanced colorectal cancer. Methods Clinical data about 98 histopathology confirmed patients with KRAS wild-type advanced colorectal cancer admitted to our hospital from February 2008 to July 2014 were collected and analyzed. Forty-four patients received cetuximab plus FOLFOX/XELOX, 54 patients received cetuximab plus FOLFIRI. Each patient received at least two cycles of chemotherapy, every 6 weeks for evaluation. The efficacy was evaluated according to RECIST 1.1. Results Ninety-eight patients were available for evaluation. In eetuximab plus FOLFOX/XELOX group, the complete response （CR） was 2.27%, partial response （PR） was 63.64%, stable disease （SD） was 25%, and progressive disease （PD） was 9.09%. In cetnximab plus FOLFIRI group, CR was 0%, PR was 40.74%, SD was 44.45%, PD was 14.81%. The objective response rate （ORR） of these two groups were 65.91% and 40.74%, respectively, which was of statistically significant difference （P=0.013）. The disease control rate （DCR） were 90.91% and 85.19% respectively, which showed statistically significant difference （P=0.390）. The median progression-free survival （PFS） was 8.4 months and 7.7 months respectively, with no statistically significant differences （P=0.580）. Conclusion The efficacy of addition of cetuximab to oxaliplatin-based chemotherapy in first-line treatment for K-RAS wild-type advanced colorectal cancer is not inferior to cetuximab combined with FOLFIRI regimen. Adverse reactions show no significant difference between the two groups, which suggests that it is worthy of promotion.

关 键 词：结直肠肿瘤 西妥昔单抗 化学治疗 

分 类 号：R735.3[医药卫生—肿瘤]