西妥昔单抗治疗中晚期恶性肿瘤的疗效和安全性评价

Efficacy and safety of cetuximab in the treatment of metastatic malignant tumor

目的:观察西妥昔单抗治疗中晚期恶性肿瘤的疗效及不良反应,研究影响疗效的主要因素。方法:回顾性分析2007年1月—2009年3月使用西妥昔单抗治疗中晚期恶性肿瘤的41例患者资料,对疗效和安全性进行评价。采用相关性和回归分析方法对可能影响药物治疗效果的因素进行统计。结果:西妥昔单抗的总有效为41.2%、疾病控制率为85.3%,对大肠癌治疗效果优于其他肿瘤,联用其他化疗药物的效果优于单用。肿瘤病理分型、HER-1受体表达和Kras基因突变与患者的药物治疗效果相关。治疗过程中共观察到36例次药品不良反应,包括皮肤毒性(29例次)、过敏反应(4例次)和低镁血症(3例次)。结论:西妥昔单抗联用其他化疗药物治疗一线化疗方案失败的大肠癌疗效确切,建议在用药前明确肿瘤病理分型、检测HER-1受体表达和Kras基因突变以预测治疗效果,治疗过程中应妥善处理严重的药品不良反应。

OBJECTIVE To investigate the response to cetuximab in the treatment of refractory metastatic malignant cancer patients. METHODS 41 refractory metastatic patients were selected from hospital information system, which received cetuximab treatment alone or combined with other antineoplastic agents during Jan. 2007 to Mar. 2009, The effects and adverse drug reactions cetuximab＇s treatment were evaluated. The potential influence factors were analyzed by crosstabs and logistic regression methods. RENULTS In all patients, the rate of response to cetuximab was 41.2% and the rate of disease control was 85.3%. It seemed that cetuximab could get a better outcome in colorectal cancer patients than others. Combined with other antineoplastic agents was superiority than that using cetuximab alone. Tumor pathology type, Her-1 receptor type and Kras gene mutation might be the influence factors which could influence cetuximab＇s treatment effect. CONCLUSION Cetuximab combined with other antineoplastic agents was active in colorectal cancer patients. It was suggested that tumor pathology type, Her-1 receptor type and Kras gene mutation should be tested in advance to predict the patients outcome.