临床荟萃

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结直肠癌抗表皮生长因子受体单抗疗效与皮疹相关性的系统评价

  

  1. 南京大学医学院附属鼓楼医院  a.老年科; b.肿瘤科, 江苏  南京 210000
  • 出版日期:2019-07-20 发布日期:2019-08-24
  • 通讯作者: 刘宝瑞,Email: baoruiliu@nju.edu.cn

Correlation between rashes and EGFR antibody response to colorectal cancer

  1. 1.Department of Geriatrics, Nanjing DrumTowel Hospital,  the Affiliated Hospital of  Nanjing University
    Medical School, 210008,  China;2.Department of Oncology, Nanjing DrumTowel Hospital, 
    the Affiliated Hospital of  Nanjing University  Medical School, 210008,  China
  • Online:2019-07-20 Published:2019-08-24
  • Contact: Corresponding author: Liu Baorui, Email: baoruiliu@nju.edu.cn

摘要: 目的  皮肤毒性是使用抗表皮生长因子受体(EGFR)单抗治疗结直肠癌中早期出现和最常见的临床现象,然而,皮肤毒性是否可以作为临床疗效指标目前仍然不明确。方法  计算机检索 Pubmed、Embase等英文数据库,检索范围从建库至2018年10月。采用STATA12.0软件进行分析,计算HR及其95% CI评价皮疹状态预测接受EGFR单抗治疗的结直肠癌患者临床预后的价值。结果  皮肤毒性严重组无进展生存期(PFS)优于皮肤毒性较弱组[HR=0.587,95%CI(0.512, 0.662),P<0.01]。此外,皮肤毒性严重组总生存期(OS)优于皮肤毒性较弱组[HR=0.512,95%CI(0.443, 0.58),P<0.01]。接受EGFR单抗治疗,KRAS突变患者肿瘤早期临床缓解率显著优于KRAS野生型[OR=3.029,95%CI(2.474, 3.708),P<0.01]。结论  皮肤毒性是结直肠癌患者的临床预后指标之一,皮肤毒性的出现提示从抗EGFR单抗治疗中获益。

关键词: 结直肠肿瘤, 受体,  , 表皮生长因子, 皮肤毒性, 疗效

Abstract: Objective  Ontreatment markers such as skin toxicity was frequent and early phenomenon in antiepidermal growthfactor receptor (EGFR)monoclonal antibody (MoAb) treatment process for colorectal cancer patients,  However,  it is still unclear  if it is a considerable marker to make treatment decision. This study aimed to uncover this issue. Methods  Literature search for relevant studies was conducted on pubmed,  Embase and other databases from their inception through Oct,  2018. The metaanalysis was then performed with STATA 12.0. The hazard ratio(HR) was calculated with a 95%  condidence intrerval(CI).Results  The presences of skin toxicity in the ongoing antiEGFR treatment was associated with longer OS (HR=0.512,95%CI[0.443,0.58],P<0.01)  and PFS (HR=0.587,95%CI[0.512, 0.662],P<0.01).  On the other hand, the early clinical remission rate of KRAS mutation patients treated with EGFR MoAb was significantly higher than that of KRAS wild type patients (OR=3.029, 95%CI[2.474, 3.708], P<0.01).Conclusion  Skin toxicity was one of prognostic factors in colorectal cancer patients. Given that skin toxicity appears to have little impact on quality of life, ontreatment markers could be potentially useful for treatment decision.

Key words: colorectal neoplasms; , receptor, , epidermal growth factor; , skin toxicity, curative effect