| 奥沙利铂+5-氟尿嘧啶/希罗达联合西妥昔单抗或单纯化疗一线用于进展期大肠癌的疗效与KRAS基因状态的关系 |
| 投稿时间：2009-11-27 修订日期：2009-12-15 点此下载全文 |
| 引用本文：田源,刘基巍,蔡欣.奥沙利铂+5-氟尿嘧啶/希罗达联合西妥昔单抗或单纯化疗一线用于进展期大肠癌的疗效与KRAS基因状态的关系[J].医学研究杂志,2010,39(3):113-116 |
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| 中文摘要:摘要目的比较奥沙利铂+5-氟尿嘧啶/希罗达联合西妥昔单抗或单独给予此化疗方案一线对于进展期大肠癌的疗效与K-ras基因状态的关系。方法A（A1、A2）、B两组患者均接受LOHP 130mg/m2,第1天静脉滴注3h，CF 200mg/m2,第1天、第2天静脉滴注2h，5-FU400mg/m2,第1天、第2天静脉推注,5-FU600mg/m2,第1天、第2天持续静脉滴注22h;或者将5-FU改换成希罗达1800mg/m2，分两次口服，第1～14天，每3周重复1次；A组患者化疗同时接受西妥昔单抗治疗，首次西妥昔单抗400mg/m2,静脉滴注小于2h，以后250mg/m2,静脉滴注小于1h，每周1次，入组患者至少连用2次，最长可持续使用至PD或者出现难以接受的毒性反应而停止。KRAS基因状态通过病理切片进行检测。结果A1组（KRAS野生型）、B组的有效率分别为54.55%、21.74%，治疗相关不良反应除皮疹外无差别。结论奥沙利铂+5-氟尿嘧啶/希罗达联合西妥昔单抗KRAS野生型患者优于单纯化疗,对于未接受治疗的患者，KRAS基因状态可以作为是否使用西妥昔单抗的一个较好的决定因素。 |
| 中文关键词:大肠癌 化疗 西妥昔单抗 KRAS基因状态 |
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| The Relationship Between KRAS Status and Response of Cetuximab in Combination with Oxaliplatin, Leucovorin and Fluorouracil/Xeloda in the First Line Treatment of Advanced Colorectal Cancer |
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| Abstract:AbstractObjectiveThis study assessed whether the best overall response rate (ORR) of cetuximab combined with oxaliplatin, leucovorin and fluorouracil/Xeloda was superior to that of this method alone as first-line treatment for metastatic colorectal cancer. The influence of KRAS mutation status was investigated. MethodsPatients received cetuximab (400mg/m2 initial dose followed by 250mg/m2，wk thereafter)less than 2 times plus chemotherapy(oxaliplatin 130mg/m2 on day 1, plus leucovorin 200mg/m2 and fluorouracil as a 400mg/m2 bolus followed by a 600mg/m2 infusion during 22 hours on days 1 and 2) or chemotherapy alone. Treatment was continued until disease progression or unacceptable toxicity. KRAS mutation status was assessed in the subset of patients with assessable tumor samples. ResultsThe confirmed ORR for cetuximab plus oxaliplatin, leucovorin and fluorouracil/Xeloda was higher than that with alone (42.86% vs 21.74%). A statistically significant increase in the odds for a response with the addition of cetuximab to oxaliplatin, leucovorin and fluorouracil/Xeloda could be established. In patients with KRAS wild-type tumors, the addition of cetuximab to oxaliplatin, leucovorin and fluorouracil/Xeloda was associated with a clinically significant increased chance of response (ORR 54.55% vs 21.74%) and a lower risk as compared with chemothrapy alone. Cetuximab plus oxaliplatin, leucovorin and fluorouracil/Xeloda was generally well tolerated. ConclusionThe clinical effcacy of chemothrapy(oxaliplatin, leucovorin and fluorouracil/Xeloda) plus cetuximab is better than only chemothrapy. KRAS mutational status was shown to be a highly predictive selection criterion in the treatment decision regarding the addition of cetuximab to oxaliplatin, leucovorin and fluorouracil/Xeloda for previously untreated patients with metastatic colorectal cancer. |
| keywords:Colorectal cancer Chemotherapy Cetuximab KRAS status |
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