西妥昔单抗联合肝动脉灌注化疗治疗结直肠癌肝转移
Cetuximab with hepatic arterial infusion of chemotherapy for the treatment of colorectal cancer liver metastases.
作者信息
Neyns Bart, Aerts Maridi, Van Nieuwenhove Yves, Fontaine Christel, De Coster Lore, Schallier Dennis, Vanderauwera Jacques, De Munck Floris, Vandenbroucke Frederik, Everaert Hendrik, Meert Vanessa, De Mey Johan, De Ridder Mark, Delvaux Georges, De Grève Jacques
机构信息
Medical Oncology, UZ Brussel, Brussels, Belgium.
出版信息
Anticancer Res. 2008 Jul-Aug;28(4C):2459-67.
BACKGROUND
Both hepatic arterial infusion (HAI) of chemotherapy and cetuximab (CET) have interesting activity for the treatment of colorectal cancer liver metastases (CRC-LM).
PATIENTS AND METHODS
Intravenous CET with HAI oxaliplatin (OXA) or i.v. Irinotecan (IRI) followed by HAI of infusion of folic acid modulated 5-fluorouracil 5-FU/l-FA was administered to patients (pts) with CRC-LM who had failed at least one line of prior chemotherapy.
RESULTS
Eight pts received i.v. CET with HAI-OXA (5 pts) and i.v.-IRI (3 pts) and HAI-5-FU/l-FA. Adverse events: repeated grade 3 skin toxicity (1 pt), abdominal pain with elevated liver enzymes and asthenia (2 pts), duodenal ulcer (2 pts) with catheter migration and intestinal bleeding (1 pt), reversible interstitial pneumonitis (1 pt), and cystic bile duct dilatation (2 pts) with arteriobiliary fistulisation (1 pt). A partial response was documented in 5 pts (62%). The median time to progression was 8.7 months (95% confidence interval 8-14 months).
CONCLUSION
Intravenous administration of CET with HAI of chemotherapy is feasible and has promising activity but is associated with specific toxicity.
背景
肝动脉灌注化疗（HAI）和西妥昔单抗（CET）对结直肠癌肝转移（CRC-LM）的治疗均具有显著活性。
患者与方法
对至少一线既往化疗失败的CRC-LM患者，静脉给予CET联合HAI奥沙利铂（OXA）或静脉给予伊立替康（IRI），随后HAI输注叶酸调节的5-氟尿嘧啶5-FU/l-FA。
结果
8例患者接受了静脉CET联合HAI-OXA（5例）和静脉-IRI（3例）及HAI-5-FU/l-FA。不良事件：反复出现3级皮肤毒性（1例）、伴有肝酶升高和乏力的腹痛（2例）、伴有导管移位和肠出血的十二指肠溃疡（2例）、可逆性间质性肺炎（1例）以及伴有动脉胆管瘘的胆囊胆管扩张（2例）。5例患者（62%）记录有部分缓解。中位进展时间为8.7个月（95%置信区间8 - 14个月）。
结论
静脉给予CET联合HAI化疗是可行的，且具有良好活性，但伴有特定毒性。
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