西妥昔单抗联合FOLFIRI 与单用FOLFIRI 方案治疗转移性结直肠癌近 期疗效的对照研究

目的:比较西妥昔单抗(爱必妥)联合FOLFIRI化疗方案与单用FOLFIRI化疗方案治疗转移性结直肠癌患者的临床疗效和毒副反应。方法:回顾性分析2008年1月至2011年11月解放军总医院经组织病理学证实的46例转移性结直肠癌患者临床资料,其中西妥昔单抗联合FOLFIRI化疗方案组22例,单用FOLFIRI方案组24例,观察比较两组方案的近期疗效和不良反应。结果:两组方案治疗转移性结直肠癌的客观缓解率(CR+PR)分别为41.6%和12.5%,其中联合治疗方案治疗效果明显优于单用FOLFIRI化疗方案,两组比较差异有统计学意义(P<0.05)。患者出现的不良反应有痤疮样皮疹、腹泻、骨髓抑制、恶心呕吐、脱发等。除痤疮样皮疹和腹泻外,两组患者毒副反应无显著性差异。结论:西妥昔单抗联合FOLFIRI化疗方案治疗K-Ras基因野生型转移性结直肠癌近期疗效显著,毒副反应较单用FOLFIRI方案无明显增加,患者可以耐受。

The Short-term Therapeutic Effect of Cetuximab Plus FOLFIRI Versus FOLFIRI Alone in the Treatment of Patients with Metastatic Colorectal Cancer

Objective: To investigate the clinical efficacy and toxicity of two regimens,cetuximab combined with FOLFIRI and FOLFIRI alone,in the treatment of patients with metastatic colorectal cancer.Methods: From Jan 2008 to Nov 2011,46 cases with metastatic colorectal cancer were studied retrospectively.All the diagnosis was confirmed by histopathology.Cetuximab combined with FOLFIRI regimen was performed in 22 K-Ras gene wild type patients and FOLFIRI alone regimen was performed in 24 patients.The data of therapeutic efficacy and toxicity was analyzed.Results: The objective response rate(CR+PR) of these two groups were 41.6% and 12.5% respectively,the therapeutic efficacy of cetuximab combined with FOLFIRI was significantly higher than FOLFIRI alone(P<0.05).The mainly adverse reactions of these patients were exanthems,diarrhea,marrow suppression,nausea and alopecia.Conclusion: The efficacy of cetuximab combined with FOLFIRI is significant for the K-Ras gene wild type patients with metastatic colorectal cancer.The toxicity between these two groups is similar and the adverse effects are tolerable.