西妥昔单抗治疗KRAS野生型转移性结直肠癌的效果及预后分析

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摘要目的探讨西妥昔单抗治疗KRAS野生型转移性结直肠癌（mCRC）患者的治疗效果和预后因素。方法回顾性分析2013年6月—2018年6月湖州市中心医院收治的接受西妥昔单抗治疗的83例KRAS野生型mCRC患者的临床病理学资料。应用Cox比例风险模型对可能影响西妥昔单抗治疗无进展生存（PFS）时间的临床病理学因素进行单因素及多因素分析，确定独立预后因素。结果经西妥昔单抗治疗的mCRC患者中，客观缓解率为63.9%，疾病控制率为86.7%。全组中位随访15.5个月，中位PFS为8.7个月，6、12、18个月PFS率分别为71.1%、32.5%、13.3%。多因素分析显示肿瘤原发部位、基线糖类抗原（CA）199水平、是否发生皮疹及严重程度及早期肿瘤退缩是患者预后的独立影响因素（P ＜ 0.05）。结论基线CA199水平、肿瘤位置、皮疹、早期肿瘤退缩可能是西妥昔单抗治疗KRAS野生型mCRC患者PFS的独立危险因素，有助于预测西妥昔单抗治疗的效果和预后。

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	钟丽萍沈俊俊韩书文齐全廖海红姜亦珍潘月芬

关键词 ：西妥昔单抗, 转移性结直肠癌, 效果, 预后

Abstract：Objective To explore the efficacy and prognostic factors of Cetuximab in the treatment of KRAS wild-type metastatic colorectal cancer (mCRC) patients. Methods A retrospective analysis of the clinicopathological data of 83 cases of KRAS wild-type mCRC patients treated with Cetuximab in Huzhou Central Hospital from June 2013 to June 2018. The COX proportional hazard model was used to conduct the univariate and multivariate analyses of the clinicopathological factors that may influence the treatment of progression free survivals (PFS) time with cetuximab to determine the prognostic factors. Results Among patients with mCRC treated with cetuximab, the objective response rate was 63.9%, and the disease control rate was 86.7%. The median follow-up for the whole group was 15.5 months, the median PFS was 8.7 months, and the PFS rates at 6, 12, and 18 months were 71.1%, 32.5% and 13.3%, respectively. Multivariate analysis showed that the primary tumor site, baseline carbohydrate antigen (CA)199 level, rash and severity and early tumor regression were independent prognostic factors(P ＜ 0.05). Conclusion Baseline CA199 level, tumor location, skin rash, and early tumor regression may be independent risk factors for PFS in patients with KRAS wild-type mCRC treated with cetuximab, and help predict the effect and prognosis of cetuximab treatment.

Key words： Cetuximab Metastatic colorectal cancer Efficacy Prognosis

基金资助:浙江省医药卫生科技计划项目（2020KY300、2019RC283）。

引用本文:

钟丽萍沈俊俊韩书文齐全廖海红姜亦珍潘月芬. 西妥昔单抗治疗KRAS野生型转移性结直肠癌的效果及预后分析[J]. 中国医药导报, 2020, 17(35): 104-107.
ZHONG Liping SHEN Junjun HAN Shuwen QI Quan LIAO Haihong JIANG Yizhen PAN Yuefen. Efficacy and prognostic analysis of Cetuximab in the treatment of KRAS wild-type metastatic colorectal cancer. 中国医药导报, 2020, 17(35): 104-107.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I35/104

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