西妥昔单抗联合化疗治疗晚期结直肠癌53例疗效分析

Gui-Fang Guo, Liang-Ping Xia, Bei Zhang, Wen-Qi Jiang, Mao-Zhen Liu, Pei-Li Hu, Xu-Xian Chen, Hui-Juan Qiu, Fei-Fei Zhou
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引用次数: 1

摘要

背景与目的:近年来研究表明西妥昔单抗联合化疗治疗晚期结直肠癌(ACRC)有效,但国内基于大病例队列的报道较少。本研究旨在分析西妥昔单抗联合化疗治疗53例中国ACRC患者的疗效。方法:分析2005年3月至2008年4月中山肿瘤中心53例ACRC患者西妥昔单抗联合化疗的临床资料,分析近期疗效和安全性。采用卡方检验比较一线与非一线治疗方案的疗效;采用多因素Cox比例风险模型分析治疗方案对预后的影响。结果:53例结直肠腺癌患者中,男性40例,女性13例,中位年龄55岁。总共完成了572周(中位8周)的西妥昔单抗治疗。总有效率(RR)为39.6%,疾病控制率为66.0%。该方案作为一线和非一线治疗时,疾病控制率相似(80.3% vs. 60.5%, P=0.177)。在所有53例患者中,临床分期是独立的预后因素(P=0.002, OR>1)。最常见的3 - 4级不良事件包括痤疮样皮疹(7.5%)、中性粒细胞减少(18.9%)和腹泻(5.6%)。未观察到过敏反应或治疗相关死亡。只有一名患者因4级腹泻和中性粒细胞减少而停止治疗。结论:西妥昔单抗联合化疗可使ACRC患者获得较高的疾病控制率,不良事件较少。西妥昔单抗在一线治疗是否优于非一线治疗,有待进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Efficacy of cetuximab combined with chemotherapy on advanced colorectal cancer: a report of 53 cases].

Background and objective: Studies showed that cetuximab combined with chemotherapy was effective on advanced colorectal cancer (ACRC) in recent years, however, few reports based on large case cohort are available in China. This study was to analyze the efficacy of cetuximab combined with chemotherapy for 53 chinese patients with ACRC.

Methods: Clinical data of 53 patients with ACRC, treated with cetuximab combined with chemotherapy in Sun Yat-sen Cancer Center from March 2005 to April 2008, were analyzed for short-term efficacy and safety. The efficacy of the regimen used as first-line and non-first-line treatment was compared by Chi-square test; the effect of the regimen on prognosis was analyzed by multivariate Cox proportional hazards model.

Results: Of the 53 patients with colorectal adenocarcinoma, 40 were men and 13 were women, with a median age of 55 years. A total of 572 weeks (median, 8 weeks) of cetuximab treatment were completed. The overall response rate (RR) of the regimen was 39.6% and the disease control rate 66.0%. The disease control rates were similar when the regimen was used as first-line and non-first-line treatment (80.3% vs. 60.5%, P=0.177). For all 53 patients, clinical stage was an independent prognostic factor (P=0.002, OR>1). The most common Grade 3 to 4 adverse events included acne-like rash (7.5%), neutropenia (18.9%), and diarrhea (5.6%). No hypersensitive reaction or treatment-related death was observed. Only one patient discontinued treatment because of Grade 4 diarrhea and neutopenia.

Conclusions: Cetuximab combined with chemotherapy can achieve relatively high disease control rate for ACRC patients, with less adverse events. Whether cetuximab has better effect in first-line treatment than in non-first-line treatment needs further study.

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