目的 探討西妥昔單抗注射液聯(lián)合FOLFOX4方案治療轉(zhuǎn)移性大腸癌的臨床療效。方法 選擇2014年6月-2015年12月解放軍第八五醫(yī)院收治的轉(zhuǎn)移性大腸癌患者75例作為研究對象，將全部患者隨機分為對照組（37例）和治療組（38例）。對照組給予FOLFOX4方案治療：第1天靜脈滴注注射用奧沙利鉑，85 mg/m²加入到5%葡萄糖溶液250 mL中；在治療第1、2天靜脈滴注氟尿嘧啶注射液，300 mg/m²加入到生理鹽水250 mL中；在第1、2天靜脈滴注亞葉酸鈣注射液，400 mg/m²加入到生理鹽水250 mL中。治療組在對照組的基礎(chǔ)上靜脈滴注西妥昔單抗注射液500 mg/m²，首次靜脈滴注時間>2 h，其后靜脈滴注時間>1 h，1次/周。2周為1個療程，兩組患者均治療4個療程。觀察兩組的臨床療效，比較兩組的腫瘤標(biāo)志物水平和不良反應(yīng)情況。結(jié)果 治療后，對照組和治療組的總有效率分別為40.5%、52.6%，疾病控制率分別為70.3%、89.5%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組血清癌胚抗原（CEA）、糖類抗原199（CA199）水平均顯著降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的下降程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。對照組和治療組皮疹總發(fā)生率分別為8.11%、34.2%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）；但其他不良反應(yīng)比較差異均無顯著性。結(jié)論 西妥昔單抗注射液聯(lián)合FOLFOX4方案治療轉(zhuǎn)移性大腸癌具有較好的臨床療效，可降低腫瘤標(biāo)志物水平，安全性好，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Cetuximab Solution for infusion combined with FOLFOX4 chemotherapy in treatment of metastatic colorectal cancer. Methods Patients (75 cases) with metastatic colorectal cancer in 85 Hospital of People's Liberation Army from June 2014 to December 2015 were randomly divided into the control group (37 cases) and the treatment group (38 cases). Patients in the control group were treated with FOLFOX4 chemotherapy and iv administered with Oxaliplatin for injection in the first day treatment, 85 mg/m² added into normal saline 250 mL. And they were also iv administered with Fluorouracil Injection in the first and second day treatment, 300 mg/m² added into normal saline 250 mL. In the same time, patients in the control group were iv administered with Calcium Folinate Injection in the first and second day treatment, 400 mg/m² added into normal saline 250 mL. Patients in the treatment group were iv administered with Cetuximab Solution for infusion on the basis of the control group, 500 mg/m², intravenous infusion of 2 h at the first time, followed by intravenous infusion of 1 h, once weekly. Patients in two groups were treated for 4 courses, 2 weeks as one course. After treatment, the clinical efficacies were evaluated, and tumor marker levels and adverse reactions in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 40.5% and 52.6%, respectively, the disease control rates in two groups were 70.3% and 89.5%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of CEA and CA199 in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). The total incidence of skin rash in the control and treatment groups were 8.11% and 34.2%, respectively, and there was difference between two groups (P<0.05). But the other adverse reactions had no significant difference between two groups. Conclusion Cetuximab Solution for infusion combined with FOLFOX4 chemotherapy has clinical curative effect in treatment of metastatic colorectal cancer, can decrease tumor marker levels with good safety, which has a certain clinical application value.