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目的：比较西妥昔单抗（爱必妥）联合FOLFIRI 化疗方案与单用FOLFIRI 化疗方案治疗转移性结直肠癌患者的临床疗效和毒副反应。方法：回顾性分析2008 年1 月至2011 年11 月解放军总医院经组织病理学证实的46 例转移性结直肠癌患者临床资料，其中西妥昔单抗联合FOLFIRI 化疗方案组22 例，单用FOLFIRI 方案组24 例,观察比较两组方案的近期疗效和不良反应。结果：两组方案治疗转移性结直肠癌的客观缓解率(CR+PR) 分别为41.6%和12.5%，其中联合治疗方案治疗效果明显优于单用 FOLFIRI 化疗方案,两组比较差异有统计学意义(P<0.05)。患者出现的不良反应有痤疮样皮疹、腹泻、骨髓抑制、恶心呕吐、脱发等。除痤疮样皮疹和腹泻外，两组患者毒副反应无显著性差异。结论：西妥昔单抗联合FOLFIRI 化疗方案治疗K-Ras 基因野生型转移性结直肠癌近期疗效显著，毒副反应较单用FOLFIRI 方案无明显增加，患者可以耐受。

英文摘要:

Objective: To investigate the clinical efficacy and toxicity of two regimens, cetuximab combined with FOLFIRI and FOLFIRI alone, in the treatment of patients with metastatic colorectal cancer. Methods: From Jan 2008 to Nov 2011,46 cases with metastatic colorectal cancer were studied retrospectively. All the diagnosis was confirmed by histopathology. Cetuximab combined with FOLFIRI regimen was performed in 22 K-Ras gene wild type patients and FOLFIRI alone regimen was performed in 24 patients. The data of therapeutic efficacy and toxicity was analyzed. Results: The objective response rate (CR+PR) of these two groups were 41.6% and 12.5% respectively, the therapeutic efficacy of cetuximab combined with FOLFIRI was significantly higher than FOLFIRI alone (P<0. 05). The mainly adverse reactions of these patients were exanthems, diarrhea, marrow suppression, nausea and alopecia. Conclusion: The efficacy of cetuximab combined with FOLFIRI is significant for the K-Ras gene wild type patients with metastatic colorectal cancer. The toxicity between these two groups is similar and the adverse effects are tolerable.

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