西妥昔单抗联合化疗治疗晚期结直肠癌的临床观察

目的：观察西妥昔单抗联合含伊立替康方案治疗国人晚期结直肠癌的近期疗效和毒副反应。方法：１４例经病理组织学检查确诊的晚期结直肠癌患者入组，为西妥昔单抗联合伊立替康单药或ＦＯＬＦＩＲＩ方案，西妥昔单抗首次给予负荷剂量４００ｍｇ／ｍ^２，而后每周维持量为２５０ｍｇ／ｍ^２。３例患者行Ｋ-ｒａｓ检测。结果：可评价病例１２例，其中ＰＲ２例，ＳＤ５例，ＲＲ１６.７％，ＤＣＲ５８.３％。１２例患者中位ＴＴＰ为９.３周。ＭＳＴ为４１.３周。２例Ｋ-ｒａｓ野生型的患者中，１例获得ＰＲ，ＴＴＰ为３２周；１例ＳＤ。１例Ｋ-ｒａｓ突变型的患者治疗２周期后ＰＤ。与西妥昔单抗相关的毒副反应为痤疮样皮疹（７８.６％）和过敏反应（１４.２％）。结论：西妥昔单抗联合化疗治疗国人晚期结直肠癌安全有效。

Clinical observation of cetuximab in combination with chemotherapy in metastatic colorectal cancer

Objective:To explore the efficacy and toxicity of cetuximab plus chemotherapy contained irinotecan or oxaliplatin in the treatment of metastatic colorectal cancer. Methods:Fourteen patients with Metastatic colorectal cancer which were histologically confirmed were treated with cetuximab in combination with CPT-11, FOLFIRI regimen or XELOX regimen. Cetuximab was given at an initial dose of 400mg/m2, followed by weekly infusions of 250mg/m2. K-ras was detected in 3 patients. Results:The effect could be evaluated in 12 patients. Two patients were PR, 5 patients SD; the rate of reponse was 16.7% and the disease control rate was 58.3%. The median time of tumor progression was 9.3 weeks. The median survival time was 41.3 weeks. One patient achieved PR,TTP 32 weeks,while another was SD in 2 patients of K-ras wild-type. One patient of K-ras mutant-type achieved PD after 2 cycles treatment. The adverse events related to cetuximab were acne-like rash(78.6%) and allergic reaction(14.2%). Conclusion:Cetuximab in combination with chemotherapy has clinically activity in patients with metastatic colorectal cancer and the toxicities were tolerable.