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目的 观察西妥昔单抗联合化疗一线治疗K-RAS野生型晚期结直肠癌的临床疗效及安全性.方法 回顾性分析2008年2月- 2014年7月我院收治的98例经病理学证实的K-RAS基因野生型晚期结直肠癌患者的临床资料,其中44例应用西妥昔单抗联合奥沙利铂+亚叶酸钙+氟尿嘧啶(FOLFOX)或奥沙利铂+卡培他滨(XELOX)方案,54例应用西妥昔单抗联合伊立替康+亚叶酸钙+氟尿嘧啶(FOLFIRI)方案治疗.每例至少接受2个周期以上化疗,每6周进行疗效评价,按照实体瘤客观疗效评价标准1.1版评价疗效.结果 98例均可进行疗效评价.其中西妥昔单抗联合奥沙利铂组完全缓解(complete response,CR) 2.27%、部分缓解(partial response,PR) 63.64%、病情稳定(stable disease,SD) 25%、病情进展(progression disease,PD) 9.09%;西妥昔单抗联合FOLFIRI组CR 0、PR 40.74%、SD 44.45%、PD 14.81%;两组客观缓解率(objective response rate,ORR)(65.91% vs 40.74%,P=0.013)差异有统计学意义,疾病控制率(disease control rate,DCR)(90.91%vs 85.19%,P=0.390)及中位无进展生存期(progression-free survival,PFS)(8.4个月vs 7.7个月,P=0.580)差异无统计学意义.结论 西妥昔单抗联合以奥沙利铂为基础的化疗方案一线治疗K-RAS野生型晚期结直肠癌患者,其疗效不劣于西妥昔单抗联合FOLFIRI方案.两组不良反应无明显差异,值得临床推广.“,”ObjectiveTo investigate the efficacy and safety of cetuximab with FOLFIRI or FOLFOX/XELOX as first-line chemotherapy for patients with K-RAS wild-type advanced colorectal cancer.MethodsClinical data about 98 histopathology confirmed patients with KRAS wild-type advanced colorectal cancer admitted to our hospital from February 2008 to July 2014 were collected and analyzed. Forty-four patients received cetuximab plus FOLFOX/XELOX, 54 patients received cetuximab plus FOLFIRI. Each patient received at least two cycles of chemotherapy, every 6 weeks for evaluation. The efficacy was evaluated according to RECIST 1.1.ResultsNinety-eight patients were available for evaluation. In cetuximab plus FOLFOX/XELOX group, the complete response (CR) was 2.27%, partial response (PR) was 63.64%, stable disease (SD) was 25%, and progressive disease (PD) was 9.09%. In cetuximab plus FOLFIRI group, CR was 0%, PR was 40.74%, SD was 44.45%, PD was 14.81%. The objective response rate (ORR) of these two groups were 65.91% and 40.74%, respectively, which was of statistically significant difference (P=0.013). The disease control rate (DCR) were 90.91% and 85.19% respectively, which showed statisticallysignificant difference (P=0.390). The median progression-free survival (PFS) was 8.4 months and 7.7 months respectively, with no statistically significant differences (P=0.580).ConclusionThe efficacy of addition of cetuximab to oxaliplatin-based chemotherapy infirst-line treatment for K-RAS wild-type advanced colorectal cancer is not inferior to cetuximab combined with FOLFIRI regimen. Adverse reactions show no significant difference between the two groups, which suggests that it is worthy of promotion.