| Objective: A retrospective study of cetuximab combined with chemotherapy for treatment of patients with advanced colorectal cancer with wild-type Ras and Braf gene,comparing right side colon cancer(RSCC)with patients with left side colon cancer(LSCC)General characteristics,progression-free survival(PFS),objective response rate(ORR),early tumor shrink(ETS),microsatellite instability(MSI)status,differences in efficacy between different chemotherapy regimens,and exploration of advanced colorectal cancer The relationship between the location of the hair and the prognosis.Method:A retrospective analysis of 123 patients with advanced colorectal cancer admitted to the Affiliated Hospital of Qingdao University from January 2017 to June 2018,all of which were genetically tested.The results showed that all Ras and Braf genes were wild-type;Divided into left and right colon cancer,and finally included 108 patients in the main analysis indicators of this study,including 76 cases of left colon cancer(including rectum),32 cases of right colon cancer,first-line use of Cetuximab combined with chemotherapy Treatment,the main outcome indicators were evaluated according to the solid tumor efficacy evaluation standard(RESIST1.1),and the parameters of PFS,ORR,MSI,ETS and other related parameters of left and right colon cancer were compared by one-way analysis of variance,using ?2 or Fisher's exact test.The Kaplan-Meier method was used for statistical analysis.Result:1.In the <60 year old patients,the right colon was more than the left colon,and in the >60 years old,the left colon was more than the right colon(P=0.026).There were no gender differences in gender,ECOG score,initial metastatic site,pathological type,related chemotherapy regimen,and treatment-related side effects in the two groups(P>0.05).2.In the first-line treatment of left and right colon cancer patients with cetuximab combined with chemotherapy,the ORR of left colon cancer and right colon cancer were 35.5% and 31.2%,respectively,and the difference was not statistically significant(p=0.669),while the left half.The PFS of colon cancer and right colon cancer were 10.3 months and 8.6 months,respectively,and the difference was statistically significant(p=0.033).3.In the left colon cancer group,cetuximab combined with chemotherapy with oxaliplatin or irinotecan,PFS was 8.6 months and 11.8 months,respectively,the difference was statistically significant(p=0.034);ORR was 37.1respectively.% and 34.1%,the difference was not statistically significant(p=0.786);for patients with advanced right colon cancer,first-line use of cetuximab combined with chemotherapy with oxaliplatin or irinotecan,PFS for 8.3 months and 8.6 The difference was not statistically significant(p=0.683);the ORR was 33.3% and 35.0%,respectively, and the difference was not statistically significant(p=0.064).4.In the left colon group,the PFS of patients with MSI-H and MSS or MSI-L in the first-line group were 9.0months and 9.1 months,respectively,and the difference was not statistically significant(P=0.901).In patients with right colon cancer,the PFS of patients with MSI-H and MSS or MSI-L were 8.7 months and 8.4 months,respectively,and the difference was not statistically significant(P=0.772).5.First-line use of cetuximab combined with chemotherapy For patients with left colon,the PFS of patients with early tumor retraction(ETS)and those without ETS were 12.3 months and 9.3 months,respectively,and the difference was statistically significant(P=0.041).For patients with right colon cancer,the PFS for patients with ETS and those without ETS were 11.6 months and 7.9 months,respectively,and the difference was statistically significant(P=0.021).Conclusion:1.Metastasis right colon cancer is more common in patients <60 years old,and in patients >60 years old,advanced left colon cancer is more common.There were no significant differences in gender?ECOG scores,initial metastatic sites,pathologic types,treatment-related chemotherapy regimens,and treatment side effects.2.Cetuximab combined with chemotherapy first-line treatment of patients with wild-type advanced colorectal cancer with Ras and Braf gene,the objective response rate was not significantly different;while the progression-free survival of patients with left colon cancer was higher than that of patients with right colon cancer.3.In patients with advanced left colon cancer with wild-type Ras and Braf genes,first-line Cetuximab combined with irinotecan-containing chemotherapy has better progression-free survival than oxaliplatin-based chemotherapy,and both are objectively relieved.The rates were similar;in patients with right colon cancer,first-line Cetuximab combined with chemotherapy containing irinotecan or oxaliplatin had similar progression-free survival and objective response rates.4.In patients with advanced colorectal cancer with wild-type Ras and Braf gene,whether it is left colon cancer or right colon cancer,the first line of Cetuximab combined with chemotherapy for MSI-H and MSS or MSI-L patients Progressive survival is similar.5.Whether it is left colon cancer or right colon cancer,patients with early tumor retraction have longer progression-free survival than those who have not achieved,and the progression of progression-free survival in the right colon cancer group is more obvious. |
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