西妥昔单抗联合FOLFIRI方案一线治疗转移性结直肠癌的疗效观察

Short-term effect of FOLFIRI chemotherapy regimen combined with cetuximab in the first-line treatment of metastatic colorectal cancer

目的:探讨西妥昔单抗(cetuximab)联合FOLFIRI一线治疗转移性结直肠癌(metastatic colorectal cancer,mCRC)的近期疗效及不良反应。方法:回顾性分析33例经组织病理学证实的K-Ras野生型mCRC患者的临床资料,其中观察组17例,一线予以西妥昔单抗联合FOLFIRI化疗方案;对照组16例,只采用FOLFIRI方案化疗。结果:两组患者的一般情况无明显差异(P>0.05)。观察组和对照组的客观缓解率分别为70.6%和31.4%(P<0.05),观察组明显高于对照组;疾病控制率分别为88.2%和81.3%(P>0.05),无明显统计学差异。观察组9例(58.8%)患者出现痤疮样皮疹,较对照组(12.5%)明显增多(P<0.05);此外包括肝损害、腹泻、白细胞减少、血小板减少等不良反应两组的发生率均无统计学差异(P>0.05)。结论:西妥昔单抗联合FOLFIRI方案一线治疗K-Ras野生型mCRC近期疗效显著,不良反应可以耐受。

Objective：To compare the short-term effect of FOLFIRI chemotherapy regimen combined with cetuximab in the first-line treatment of metastatic colorectal cancer（mCRC）.Methods：A total of 33 patients with mCRC were studied retrospectively.All the diagnosis was confirmed by histopathology and the K-Ras gene was wild type.Cetuximab combined with FOLFIRI regimen was performed in 17 patients and FOLFIRI alone regimen was performed in 16 patients.The data of therapeutic efficacy and toxicity was analyzed.Results：No significantly difference was found between the two groups of patients＇ baseline status.The disease control rate of these two groups were 88.2% and 81.3%（P〉0.05）,and the objective response rate of these two groups were 70.6% and 31.4%（P〈0.05） respectively,which indicated that the therapeutic efficacy of cetuximab combined with FOLFIRI was significantly higher than FOLFIRI alone.The mainly adverse effects of the treatment group is exanthemas,which happens more than in the control group（P〈0.05）.The other adverse effects,including marrow suppression,diarrhea and hepatic function lesion,didn＇t show significant statistics difference in two groups.Conclusion：The efficacy of cetuximab combined with FOLFIRI regimen as first-line treatment is significant for the K-Ras gene wild type patients with mCRC.The toxicity between these two groups is similar and the adverse effects are tolerable.