西妥昔单抗联合放化疗治疗中晚期恶性肿瘤

Cetuximab plus chemotherpay and/or radiotherapy in the treatment of refractory metastatic cancer

背景与目的:西妥昔单抗是一种特异性阻断EGFR的单克隆抗体。本研究观察西妥昔单抗联合放化疗治疗晚期头颈部和结直肠癌的有效性和安全性。方法:全组6例患者,均经病理证实,西妥昔单抗联合伊立替康、卡培他滨方案治疗晚期结直肠癌;联合多西他赛、放疗治疗晚期头颈鳞癌。西妥昔单抗首剂400mg/m2,然后250mg/m2每周1次维持。结果:6例患者治疗后取得PR2例,SD3例,PD1例,中位TTP18.5周。其中3例晚期头颈鳞癌患者,PR1例,SD2例;3例晚期中分化结直肠癌患者,PR1例,SD1例,PD1例。主要的毒性反应是痤疮样皮疹和腹泻。结论:西妥昔单抗联合多西他赛+放疗治疗晚期头颈鳞癌,西妥昔单抗联合伊立替康、卡培他滨治疗晚期结直肠癌患者有效。除皮疹之外,毒副反应较单用化疗、放疗无明显增加。

Background and purpose： Cetuximab is a monoclonal antibody that specifically blocks the EGFR. We explored the efficacy and toxicity of cetuximab plus chemotherapy and/or radiotherapy in the refractory metastatic patients with head and neck cancer and colorectal cancer. Methods： Six patients of refractory metastatic cancer were treated with cetuximab in combination with radiotherapy and chemotherapy. All patients were confirmed by histological diagnosis. Three patients were diagnosed as refractory metastatic head and neck cancer and others as refractory metastatic colorectal cancer. The patients of head and neck cancer were treated with docetaxel and radiotherapy in combination with eetuximab. The patients of colorectal cancer were treated with irinotecan and capecltabine. Cetuximab was given at an initial dose of 400 mg/ m^2, followed by weekly infusions of 250 mg/m^2. Results： 2 patients with PR, 3 patients with SD and 1 patient with PD. the median time of tumor to progression（TTP） was 18.5 weeks. The major toxicities were acne-like rash and diarrhea. Conclusions： Cetrximab in combination with chemotherapy and/or radiotherapy has clinically significant activity in patients with refractory metastatic cancer. The toxicity except rash was not more frequent among the patients receiving eetuximab in combination with chemotherapy and/or radiotherapy than chemotherapy and/or radiotherapy alone.