摘要
目的评价西妥昔单抗联合mFOLFOX6一线治疗k-ras野生型结直肠癌肝转移患者的临床疗效及安全性。方法本院自2008年1月至2011年12月收治的失去手术机会的晚期结直肠癌肝转移患者39例,其中一线接受西妥昔单抗联合mFOLFOX6方案治疗19例(联合组),单用mFOLFOX6方案化疗20例(化疗组),具体方案为:西妥昔单抗首次400 mg/m2,静脉滴注120 min,后续每周250 mg/m2,静脉滴注60 min,每周给药1次或500 mg/m2,首次静脉滴注120 min,之后每次滴注60 min,每2周给药1次;mFOLFOX6方案:奥沙利铂85 mg/m2,第1天,LV 400 mg/m2,第1天,5-FU 400 mg/m2,静推,第1天,2400 mg/m2,持续静注46 h,2周为一周期;化疗组仅接受上述mFOLFOX6方案化疗。结果全组39例患者均可评价疗效,联合组获得CR 2例(10.5%),PR 11例(57.9%),SD 4例(21.1%),PD 2例(10.5%),RR为68.4%,DCR为89.5%。化疗组获得CR为0例,PR 6例(30.0%),SD 8例(40.0%),PD 6例(30.0%),RR为30.0%,DCR为70.0%。两组缓解率RR比较有统计学差异(P=0.016),中位PFS分别为10.4个月、6.3个月,联合组优于化疗组;获得R0肝转移灶切除者两组分别为36.8%vs.10.0%(P=0.047),手术者PFS分别为12.6个月、15.6个月,均优于未获得手术机会的患者;主要不良反应为皮疹、腹泻、恶心呕吐、神经毒性及血液学毒性,均可耐受。结论西妥昔单抗联合mFOLFOX6一线治疗k-ras野生型晚期结直肠癌肝转移患者,获得较好的临床缓解率及更高的肝切除率,获得R0肝转移灶切除的患者可以获得更高的疾病无进展时间,两组不良反应均可耐受,值得在临床推广应用。
Objective To assess the efficacy and adverse effects of cetuximab plus mFOLFOX6 as first-line treatment for K-Ras wild type patients with unresectable colorectal liver metastases. Methods From January 2008 to December 2011, 39 patients with unresectable liver metastases from k-ras wild-type colorectal cancer were assigned, while 19 patients were treated with cetuximab （500 mg/m2 iv ） biweekly plus mFOLFOX6 （L-OHP 100 mg/m2, leucovorin 400 mg/m2, 5-fluorouracil 400 mg/m2 bolus and 5-fluorou- racil 2400 mg/m2 46-hour infusion, biweekly） and 20 patients received mFOLFOX6 only. Results In two teams, RR was 57.9% vs. 30.0%, DCR was 84.2% vs. 70.0%, mPFS was 10.4 vs. 6.3 months; The liver resection rate was 26.3% （5/19） vs. 10.0% （2/20）, the PFS was 12.6 and 15.6 months,longer than these who had no chance of resection. The common adverse events were skin rash, digestive reaction and neutropenia, mainly in grade 1-2. Conclusion Cetuximab plus mFOLFOX6 in k-ras wild-type patients with unresectable liver metastases from colorectal cancer is effective and the adverse effect is tolerate, worth further study.
出处
《中华临床医师杂志（电子版）》
CAS
2013年第19期41-43,共3页
Chinese Journal of Clinicians(Electronic Edition)
