Study On Hemostatic Effects And Mechanism Of Cetuximab Combine Chemotherapy

Objective: The purpose of this study is to investigate the further clinical efficacyand adverse reactions of cetuximab combination with chemotherapy in the treatment ofadvanced malignant cancer.Methods:52patients’ information who were received cetuximab treatment werecollected in our hospital since Jul2007till Sep2012. All patients were pathologicallydiagnosed as malignant. The data is divided into two types of gastrointestinal cancerand Recurrent/Metastatic squamous cell carcinoma of the head and neck（R/M SCCHN）.Gastrointestinal cancer: colon cancer in23cases, blind colorectal cancer in1cases,colorectal cancer in12patients and4cases of gastric cancer; R/M SCCHN:Nasopharyngeal carcinoma12cases.25females,27males; Ages ranging from17-83years old,with a midian age of51.2years. In gastrointestinal cancer patients,33patientsare re-treatment, Seven was initial teeatment, all head and neck cancer patients arere-treatment. The patients with gastrointestinal cancer received FOLFIRI(irinotecan,irinotecan fluorouracil,leucovorin) combine cetuximab, the FOLFIRI every21days for1cycle, chemotherapy2-6cycles, the average of4.3cycles; patients withSCCHN received FP (5-Fu+cisplatin) combined with cetuximab,the FP program every21days for1cycle, chemotherapy4-6cycles, the average of5.3cycles. Cetuximab withconcurrent chemotherapy administration methods: A loading dose of400mg/m2followed by a maintenance dose of250mg/m2per week, until disease progression ordifficult to tolerate cetuximab-related adverse reactions or disabled due to economicreasons. Ranging from3-17times(an average of7.125times). Efficacy evaluation afterevery two cycles of chemotherapy.Results:52patients, the overall efficacy evaluation: CR0(0%), PR10(18.5%),SD26(50.0%) and PD16(30.8%), the objective response rate was19.2%, and the disease control rate was69.2%. In40cases of gastrointestinal tumors, CR0, PR8, SD20and PD12, the response rate was20.0%, disease control rate was70.0%,36cases ofcolorectal cancer patients treated was22.2%of response rate,4cases of patients withgastric cancer treatment was0%.12cases of patients with SCCHN, CR0, PR2, SD6,PD4, the response rate was16.7%, disease control rate was66.7%. Analysis of theefficacy factor such as the patient’s gender, location, degree of differentiation and otherrelevant factors for the treatment of gastrointestinal tumors, CR+PR to be effective,SD+PD to be uneffective, the results showed pathological type was related to efficacy(P <0.05). In all patients,39cases (75.0%) had varying degrees of adverse drugreactions, the main adverse reactions of I-II level: rash in28cases (53.8%), neutropeniain18patients (34.6%), nausea vomiting in13cases (30.8%), diarrhea in13cases(30.8%), constipation in4cases (7.7%), abnormal liver function in8patients (15.4%);III-IV adverse reactions: rash(7.7%), neutropenia (11.5%), diarrhea (3.8%),constipation (1.9%). CR+PR patients compared with SD+PD patients moresusceptible to skin rashes, but no significant difference (P>0.05).Conclusion:1. Cetuximab combined with chemotherapy in treatment of gastrointestinal tumorsis effective, the response rate was20.0%, disease control rate was70.0%, in treatmentof head and neck squamous cell carcinoma the effective rate was16.7%, disease controlrate was66.7%.2. The response rate in the colorectal cancer therapy was higher than head and necksquamous cell carcinoma.3. The best efficacy of cetuximab treatment in gastrointestinal cancer is colorectalcancer.4. It is a low incidence of adverse reactions in cetuximab combination withchemotherapy. III-IV adverse events were rash, neutropenia, diarrhea.5．It was no correlation between rash and efficacy.