西妥昔单抗联合化疗初始治疗转22例移性结直肠癌的近期疗效观察

Clinical Effect of Cetuximab Combined with Chemotheraphy on Metastastic Colorectal Cancer

目的:观察西妥昔单抗联合含奥沙利铂或伊立替康方案初始治疗转移性结直肠癌及其可评价病灶的近期疗效及全身副反应。方法:选取2007年6月1日至2008年6月30日本院22例经病理学确诊的转移性结直肠癌患者,随机分两组,应用西妥昔单抗(爱必妥):首剂400mg/m^2,次周250mg/m^2,每周1次,分别联合FOLFIRI方案(CPT-11 180mg/m。,d1,CF400mg/m^2,d1,5-FU400mg/m^2,静脉推注d1,5-FU 2.4mg/m^2连续输注46h,d1～2,2周重复一次)和mFOLFOX6(L-OHP 85mg/m^2,d1,CF400mg/m^2,d1,5-FU 400mg/m^2,静脉推注,d1,5-FU 2.4mg/m^2连续输注46h,d1～2,2周重复一次)行靶向治疗联合化疗,每4周评价疗效。结果:全组有21例可评价疗效,部分缓解(PR)12例,疾病稳定(SD)6例,有效率(RR)57.1%,疾病控制率(CR+PR+SD)85.7%,其中2例肝转移患者PR后行肝脏射频治疗,2例行Ⅰ期转移灶切除术,转移灶转化可切除率23.5%,使原来无法切除的转移瘤得以切除,主要不良反应为皮肤痤疮样皮疹和骨髓抑制。结论:西妥昔单抗联合含奥沙利铂或伊立替康方案初始治疗转移性结直肠癌安全有效,并一定程度上转化肝转移病灶,提高结肠癌肝转移手术切除率,可能改善预后,这将为转移性结直肠癌新的治疗策略提供有力证据。

Objective： To evaluate the efficacy and the adverse reactoions of cetuximab combined with cheomotherapy （oxapliplatin or iriticon） for metastastic colorectal cancer. Methods： A total of 22 patients with metastastic colorectal cancer were treated with cetuximab combined with FOLFIRI or mFOLFOX6. The patients received cetuximab at an initial dose of 400 mg/m2 intravenously on day 1 in the first cycle, followed by weekly infusion of 250 mg/m2; FOLFIRI： irinotecan 180 mg/ m2 on day 1, CF 400 mg/m2, 5-FU bolus 400 mg/m2, 5-FU infusion 2400 mg/m2 over 46 hours, once every 2 weeks; mFOLF- OX6： oxaliplatin 85mg/m2 on day 1, CF 400 mg/m2, 5-FU bolus 400 mg/m2, 5-FU infusion 2400 mg/m2 over 46 hours, once every 2 weeks. The immediate response, complete response and partial response and changes in tumor marker levels were observed. Results： There were 12 PR cases, 6 SD cases, and no CR cases. The rate of （CR＋PR） was 57.1% and the rate of （CR＋PR＋SD） was 85.7%. The adverse reactions during the theraphy were skin toxicity and neutropenia. Conclusion： Safe and effective for metastastic colorectal cancer, cituximab combined with oxaliplatin or idnotecan can increase the resectabiliy rate and prolong patient survival.