个体化方案治疗转移性直肠癌临床对照研究.doc

个体化方案治疗转移性直肠癌的临床对照研究 杨华清 （广元市中心医院肿瘤科 四川广元 628400） [摘要] 目的：探讨个体化化疗方案治疗直肠癌的疗效。方法：将转移性直肠癌患者60名，治疗前随机分为两组：一组采用传统的化疗方法，另一组30例中采用个体化化疗方案，后组采用个性化用药诊断试剂盒检测30例直肠癌活检新鲜肿瘤标本组织中的mRNA表达水平，基因多态性，筛选合适的化疗药物，并通过检测肿瘤组织中的基因突变，决定是否加用分子靶向药物：西妥昔单抗。结果：60例转移性直肠癌患者，传统治疗组30例化疗6- 8周后，取得完全缓解(CR)4例, 部分缓解(PR)13例, 稳定(SD)8例, 进展(PD)5例，总有效率(RR)为56.7％(17/30), 疾病控制率(DCR)为83.3％(25/30)。个体化化疗方案治疗6- 8周后，取得完全缓解(CR)7例, 部分缓解(PR)16例, 稳定(SD)5例, 进展(PD)2例，总有效率(RR)为76.7％(23/30), 疾病控制率(DCR)为93.3％(28/30)。结论：个体化化疗方案治疗直肠癌的疗效优于传统的直肠癌的化疗方案，值得推广应用。 [关键词] 直肠癌；个体化治疗；分子标志 Clinical Randomized Research of Individualized Chemotherapy for Treating Metastatic Rectal Cancer Yang Hua-qing (Department of Oncology, The Central Hospital of GuangYuan, 628400) [Abstract] Objective To investigate the effect of individualized chemotherapy for rectal cancer. Methods 60 patients who needed chemotherapy treatment for metastatic rectal cancer were randomly divided into two groups: the traditionary chemotherapy group and individualized chemotherapy group. In individualized chemotherapy group ，individualized medical diagnostic kits were used to detect mRNA expression level and gene polymorphism in fresh tumor biopsy specimens from 30 patients with rectal cancer and to screen for appropriate chemotherapy medicine. Also, gene mutation in tumor tissue was detected to determine whether to add the molecular targeted drugs, cetuximab or not. Results 30 patients with metastatic rectal cancer were treated with the traditionary chemotherapy for 6 to 8 weeks. There were 4 cases of complete remission(CR), 13 cases of partial remission(PR), 8 cases of stable disease(SD)and 5 cases of progression disease(PD) with?a?56.7%(17/30) objective?efficiency?rate（RR）%(25/30) disease?control?rate（DCR） patients with metastatic rectal cancer were treated with individualized chemotherapy for 6 to 8 weeks. There were 7 cases of complete remission(CR), 16 cases of partial remission(PR), 5 cases of stable disease(SD)and 2 cases of progression disease(PD) with?a?76.7％(23