目的 观察西妥昔单抗联合FOLFOX4方案一线治疗转移性结直肠癌的临床疗效和毒副反应.方法 回顾性分析2008年4月至2011年10月经组织病理学证实的转移性结直肠癌患者36例,其中治疗组(n=18)采用西妥昔单抗(500mg/m2静滴120min,每周1次,使用6～12次)联合FOLFOX4方案(奥沙利铂85mg/m2静滴2h,d1；左亚叶酸钙200mg/m2静滴2h,d1、d2；氟尿嘧啶400mg/m2静滴,d1、d2；氟尿嘧啶600mg/m2持续静脉泵入22h,d1、d2.14天为1周期,化疗不超过12个周期.)治疗.对照组(n=18)仅用FOLFOX 4方案化疗,同治疗组.结果 治疗组与对照组的客观缓解率分别为66.7％和22.2％ (P ＜0.05),疾病控制率分别为94.4％和67.7％ (P ＞0.05).治疗组和对照组痤疮样皮疹发生率分别为38.9％和0,其他不良反应包括骨髓抑制、恶心呕吐、神经毒性、肝脏损害及脱发等,差异均无统计学意义(P＞0.05).结论 西妥昔单抗联合FOLFOX 4方案治疗转移性结直肠癌的近期疗效显著,毒副反应可耐受.%Objective To evaluate the clinical efficacy and toxicity of cetuximab combined with FOLFOX 4 regimen as the first-line treatment for metastatic colorectal cancer. Methods From April 2008 to October 2011 retrospective analysis was performed on 36 cases with metastatic colorectal cancer confirmed by histopathology. Eighteen patients received cetuximab combined with FOLFOX 4 regimen (cetuximab 500mg/m2 iv 120min, once a week,6-12 times;oxaliplatin 85mg/m2 iv 2h d,;calcium cevofolinate 200mg/m2 iv 2h, d1, d2 ;fluorouracil 400mg/m2 iv, d,, d2 ;fluorouracil 600mg/m2 civ 22h, d,, d2. Fourteen days was a cycle, and each patient received at most 12 cycles). The other 18 patients received the treatment of FOLFOX 4 regimen alone with the same usage and dose as combination group. Results The objective response rate of cetuximab combined with FOLFOX 4 regimen and FOLFOX 4 regimen a-lone were 66.1% and 22. 2% (P<0.05), and the disease control rate were 94.4% and 67.1% (p>0.05). The incidence of exan-thems in the group of cetuximab combined with FOLFOX 4 regimen and FOLFOX 4 regimen alone was 38.9% and 0. The other adverse effect included marrow suppression, nausea and vomitting, neurotoxicity, liver damage and alopecia( P > 0.05). Conclusion The short -term clinical efficacy of cetuximab combined with FOLFOX4 regimen is significant for the patients with metastatic colorectal cancer, and the toxicity is well tolerated.
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