奥沙利铂或伊立替康联合氟尿嘧啶在KRAS突变型的晚期结直肠癌一线化疗中的疗效比较  

Comparison of oxaliplatin-based and irinotecan-based regimen in the first-line treatment of KRAS mutation advanced colorectal cancer

作　　者：叶炜芃 陈燕贤[2] 王慧中[3] 李炜玉[3] 杨琼[3] 谢德荣[3] 

机构地区：[1]广州医科大学附属第五医院肿瘤科,广州510700 [2]汕头大学医学院附属肿瘤医院肿瘤科,广东汕头515000 [3]中山大学孙逸仙纪念医院肿瘤科,广州510120

出　　处：《岭南现代临床外科》2016年第5期553-556,共4页Lingnan Modern Clinics in Surgery

基　　金：广东省科技计划项目(2009B030801195)

摘　　要：目的有研究认为KRAS突变型晚期结直肠癌对奥沙利铂较为敏感,本文在前期研究的基础上扩大样本量,探讨KRAS突变型患者一线以奥沙利铂为基础化疗方案是否优于伊立替康为基础化疗方案。方法回顾分析2005年4月~2016年6月期间5个中心、经病理和基因检测确诊的112例KRAS基因突变型晚期结直肠癌患者,一线接受奥沙利铂为基础化疗方案72例,伊立替康为基础方案40例,主要观察终点指标OS,次要终点指标为DCR、PFS。结果奥沙利铂组与伊立替康组的中位OS分别为24.9个月和26.5个月（P=0.978）、DCR分别为69.4%和62.5%（χ~2=0.561,P=0.454）、中位PFS分别为8.5个月和8.5个月（P=0.412）,两组差别均无统计学意义。结论 KRAS基因突变型晚期结直肠癌患者,一线应用奥沙利铂与伊立替康为基础化疗方案相比疗效无差异。Objective Some researches found that KRAS mutation advanced colorectal cancer may predict sensitivity to oxaliplatin. This acticle enlarge more samples based on previous research. Objective to investigate which is the better regimen for KRAS mutation advanced colorectal cancer. Methods Between 2005 and 2016, 112 advanced colorectal cancer patients with KRAS mutation were retrospectively analyzed. Of them 72 patients received first-line oxaliplatin-based chemotherapy while 40 patients received iriontecan-based chemotherapy. The primary endpoint was overall survival, the secondary endpoints were disease control rates and progression-free survival. Results Median overall survival was 24.9 months for oxaliplatin and 26.5 months for iriontecan （P=0.978）, with DCR was 69.4% and 62.5%, respectively （χ2=0.561,P=0.454）. Median progression-free survival was 8.5 months for oxaliplatin and 8.5 months for iriontecan which had no statistical significance （P=0.412）. Conclusion It was demonstrated that oxaliplatin-hased chemotherapy and iriontecan-based chemotherapy in the first-line had similar efficacy in patients with KRAS mutation advanced colorectal cancer.

关 键 词：KRAS突变 晚期结直肠癌 奥沙利铂 伊立替康 氟尿嘧啶 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]