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[目的]观察西妥昔单抗对K-ras野生型转移性结直肠癌的疗效和不良反应。[方法]对34例接受西妥昔单抗单药(1例)或联合化疗(33例)治疗的K-ras野生型转移性结直肠癌患者进行疗效及不良反应分析。[结果]34例患者均可评价疗效及不良反应。全组有效率41.2%,中位无进展生存时间6.5个月,中位生存时间16.9个月。7例一线治疗患者有效率57.1%,中位无进展生存时间7.2个月,中位生存时间21.4个月。21例二线治疗患者,有效率38.1%,中位无进展生存时间6.9个月,中位生存时间15.7个月。6例三线或三线以上患者,有效率33.3%。最常见的不良反应为皮肤毒性,其次骨髓抑制,大多为Ⅰ～Ⅱ度。[结论]国人K-ras野生型转移性结直肠癌患者中,西妥昔单抗联合化疗在一线、二线及多线治疗中均获得较好的客观缓解及疾病控制,同时不良反应可耐受。
[Objective] To observe the efficacy and adverse reactions of cetuximab in K-ras wild-type metastatic colorectal cancer. [Method] The efficacy and adverse reactions of 34 patients with K-ras wild-type metastatic colorectal cancer treated with cetuximab monotherapy (1 case) or combination chemotherapy (33 cases) were analyzed. [Result] All the 34 patients could evaluate the curative effect and adverse reaction. The overall efficiency of 41.2%, median progression-free survival time of 6.5 months, the median survival time of 16.9 months. Seven cases of first-line treatment of patients with an efficiency of 57.1%, median progression-free survival time of 7.2 months, the median survival time of 21.4 months. Among the 21 second-line patients, the effective rate was 38.1%, the median progression-free survival time was 6.9 months, and the median survival time was 15.7 months. 6 cases of three or more than three patients, the effective rate of 33.3%. The most common adverse reactions for the skin toxicity, followed by bone marrow suppression, mostly for Ⅰ ~ Ⅱ degrees. [Conclusion] Among patients with K-ras wild-type metastatic colorectal cancer in China, cetuximab combined with chemotherapy achieved good objective remission and disease control in the first-, second- and multi-line treatment, and the adverse reactions were tolerable .