西妥昔单抗联合化疗治疗晚期结直肠癌的临床观察

Clinical observation of cetuximab in combination with chemotherapy in metastatic colorectal cancer

目的:观察西妥昔单抗联合含伊立替康方案治疗国人晚期结直肠癌的近期疗效和毒副反应。方法:14例经病理组织学检查确诊的晚期结直肠癌患者入组,为西妥昔单抗联合伊立替康单药或FOLFIRI方案,西妥昔单抗首次给予负荷剂量400mg/m2,而后每周维持量为250mg/m2。3例患者行K-ras检测。结果:可评价病例12例,其中PR 2例,SD 5例,RR16.7%,DCR 58.3%。12例患者中位TTP为9.3周。MST为41.3周。2例K-ras野生型的患者中,1例获得PR,TTP为32周;1例SD。1例K-ras突变型的患者治疗2周期后PD。与西妥昔单抗相关的毒副反应为痤疮样皮疹(78.6%)和过敏反应(14.2%)。结论:西妥昔单抗联合化疗治疗国人晚期结直肠癌安全有效。

Objective：To explore the efficacy and toxicity of cetuximab plus chemotherapy contained irinotecan or oxaliplatin in the treatment of metastatic colorectal cancer. Methods：Fourteen patients with Metastatic colorectal cancer which were histologically confirmed were treated with cetuximab in combination with CPT-11, FOLFIR1 regimen or XELOX regimen. Cetuximab was given at an initial dose of400mg/m2, followed bv weekly infusions of 250mg/rn2. K-ras was detected in 3 patients. Results：The effect could be evaluated in 12 patients. Two patients were PR, 5 patients SD; the rate of reponse was 16. 7% and the disease control rate was 58.3%. The median time of tumor progression was 9. 3 weeks. The median survival time was 41.3 weeks. One patient achieved PR,TTP 32 weeks,while another was SD in 2 patients of K-ras wild-type. One patient of K-ras mutant-type achieved PD after 2 cycles treatment. The adverse events related to cetuximab were aene-like rash （78.6%） and allergic reaction （ 14. 2% ）. Conclusion：Cetuximab in combination with chemotherapy has clinically activity in patients with metastatic coloreetal cancer and the toxicities were tolerable.