含西妥昔单抗化疗方案对k-ras基因野生型结直肠癌肝转移手术切除率的影响

Effect of cetuximab chemotherapy on operation resection rate of wild type k-ras gene in liver metastasis of colorectal cancer

目的 探讨对k-ras野生型结直肠癌肝转移患者应用西妥昔单抗联合mFOLFOX6方案一线治疗的临床效果及安全性.方法 选择经病理组织学检测确诊为k-ras野生型结直肠癌合并肝转移的患者40倒,其中应用西妥昔单抗联合mFOLFOX6方案的20例患者作为观察组,仅仅应用mFOLFOX6进行化疗的20例患者作为对照组,观察两组药物治疗的效果及安全性.结果 （1）观察组RR、手术切除率及R0切除率（60％、45％、35％）明显高与对照组（30％、15％、10％）,差异有统计学意义（x2=3.95、4.36、4.28,均P＜0.05）;观察组PFS（16.37 ±7.24）,略高于对照组的（11.52±6.85）,但是差异无统计学意义（P＞0.05）;（2）观察组中出现皮疹患者2例,白细胞减少2例,恶心、呕吐1例,不良反应发生率为25％ （5/20）;对照组出现白细胞减少患者2例,恶心、呕吐1例,未见皮疹及甲沟炎,不良反应发生率为15％ （3/20）,两组患者不良反应发生率差异无统计学意义（P＞0.05）.结论 西妥昔单抗联合FOLFOX6能够有效的提高k-ras野生型结直肠癌肝转移患者临床缓解率及病灶切除率,并且安全性高,值得在临床上推广应用.

Objective To explore the clinical effect and safety of cetuximab plus mFOLFOX6 first-line treatment in k-ras wild type patients with liver metastasis from colorectal cancer.Methods 40 k-ras wild-type colorectal cancer patients with liver metastasis diagnosed by histological detection in our hospital were chosen.20 patients in the observation group were treated with cetuximab plus mFOLFOX6.20 patients in the control group were only given mFOLFOX6.To observe the effect and safety of the two groups.Results RR,operation excision rate and R0 removal rate of observation group （60%,45%,35%） were significantly higher than those of the control group （30%,15%,10%）,the differences were statistically significant （x2 =3.95,4.36,4.28,P 〈 0.05）;The PFS of the observation group （16.37 ± 7.24） was higher than （11.52 ± 6.85） in the control group,but the difference was not statistically significant （P 〉 0.05）.In the observation group,there were 2 cases with rash,2 cases of leukopenia,1 case with nausea and vomiting,the incidence rate of adverse reaction was 25 % （5/20） ;In the control group,there were 2cases with leukopenia,1 case with nausea and vomiting,there was no rash and paronychia,the incidence rate of adverse reaction was 15% （3/20）,there was no significant difference in incidence rate of adverse reaction between the two groups （P 〉 0.05）.Conclusion Cetuximab combined with FOLFOX6 can improve the performance clinical remission rate and lesion resection rate of k-ras wild type patients with liver metastases from colorectal cancer,and has high safety,which is worthy of clinical application.