Guo Gui-Fang, Xia Liang-Ping, Zhang Bei, Jiang Wen-Qi, Liu Mao-Zhen, Hu Pei-Li, Chen Xu-Xian, Qiu Hui-Juan, Zhou Fei-Fei
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, 510060, P. R. China.
Ai Zheng. 2009 Dec;28(12):1317-23. doi: 10.5732/cjc.009.10209.
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.
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.
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.
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.
近年来研究显示，西妥昔单抗联合化疗对晚期结直肠癌（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对53例中国ACRC患者的疗效。
分析2005年3月至2008年4月在中山大学肿瘤防治中心接受西妥昔单抗联合化疗的53例ACRC患者的临床资料，观察短期疗效和安全性。采用卡方检验比较该方案作为一线及非一线治疗的疗效；采用多因素Cox比例风险模型分析该方案对预后的影响。
53例结直肠癌患者中，男性40例，女性13例，中位年龄55岁。共完成西妥昔单抗治疗572周（中位8周）。该方案的总缓解率（RR）为39.6%，疾病控制率为66.0%。该方案作为一线及非一线治疗时的疾病控制率相似（80.3%对60.5%，P = 0.177）。对所有53例患者而言，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。仅1例患者因4级腹泻和中性粒细胞减少而停药。
西妥昔单抗联合化疗对ACRC患者可达到较高的疾病控制率，且不良事件较少。西妥昔单抗在一线治疗中是否比非一线治疗效果更好，有待进一步研究。
