不同原发肿瘤位置对于西妥昔单抗联合化疗治疗K-ras基因野生型的转移性结直肠癌患者的预后比较

Comparison of the Prognosis of Different Primary Tumor Location in Patients with K-ras Wild Type Metastatic Colorectal Cancer treated with Cetuximab Combined Chemotherapy

目的:探讨不同原发肿瘤位置对于西妥昔单抗治疗K-ras基因野生型的转移性结直肠癌患者的预后影响。方法:回顾性分析2008年1月1日至2013年12月31日187例我院行西妥昔单抗联合FOLFOX或FOLFIRI治疗的转移性结直肠癌患者,根据原发肿瘤位置,以结肠左曲为分界点分为右半结肠癌和左半结肠癌两组,按照严格的配对标准进行1:2配对,最终获得右半结肠癌组16例,左半结肠癌组32例,进行分析,比较两组患者的近期疗效和无进展生存期。结果:右半结肠癌组ORR为56.3%,左半结肠癌组ORR为62.5%,2组比较差异无统计学意义(X2=0.174,P=0.676)。右半结肠癌组DCR为87.5%,左半结肠癌组DCR为93.7%。2组比较差异无统计学意义(X2=0.545,P=0.460)。右半结肠癌组的中位无进展生存时间(m PFS)为5.0个月,左半结肠癌组mPFS为7.7个月,两组差别有统计学意义(P<0.05)。结论:K-Ras基因野生型的左半结肠癌患者应用西妥昔单抗治疗,预后好于右半结肠癌。

Objective：To explore the influence of the prognosis of different primary tumor location in patients with K-ras wild type metastatic colorectal cancer treated with cetuximab.Methods：The clinicopathologic data of 187 cases with K-ras wild type mCRC who had treated with cetuximab combined with FOLFOX or FOLFIRI chemotherapy were analyzed retrospectively.Left-sided primary tumors（LC）were defined as tumors from rectum to left flexure,while tumors in the remaining colon were regarded right-sided primary tumors（RC）.According to the strict standards for pairing 1：2 matched,16 patients in RC and 32 patients in LC were statistically analyze.Results：The ORR in group RC and LC were 56.3% and 62.5%.The DCR in group RC and LC were 87.5% and 93.7%.There were no significant differences in the objective response rate and disease control rate between two group.The median PFS in group RC and group LC were 5 and 7.7 months,with a statistically significant difference（P0.05）.Conclusions：Left sided primary tumors are associated with favorable prognosis in patients with K-ras wild type mCRC treated with cetuximab.