贝伐珠单抗联合化疗治疗转移性结直肠癌的疗效和安全性

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目的:观察贝伐珠单抗联合化疗治疗转移性结直肠癌(metastatic colorectal cancer,mCRC)的疗效和安全性.方法:回顾分析2012-01/2015-07在新疆肿瘤医院接受贝伐珠单抗联合化疗的mCRC患者71例,观察其临床疗效和贝伐珠单抗相关的不良反应.至少2个周期贝伐珠单抗治疗后评估疗效,每周期治疗后记录不良反应.结果:71例mCRC患者,客观缓解率(response rate,RR)为29.6%,疾病控制率(disease control rate,DCR)为78.9%.一线治疗组RR为35.6%,DCR为88.9%.二线治疗组RR为19.2%,DCR为61.5%.一线治疗组中位无进展生存时间(median progress-free survival,mPFS)和中位总生存时间(median overall survival,mOS)分别为8.2 mo和20.9 mo.二线治疗组的mPFS和mOS分别为4.4 mo和14.7 mo.一线化疗后接受维持治疗与未接受维持治疗的mPFS分别为11.7 mo和7.7 mo(P<0.0001).与贝伐珠单抗治疗相关的不良反应主要为高血压、蛋白尿和出血等,绝大多数为1-2级.结论:本研究表明贝伐珠单抗联合化疗对mCRC患者是获益的,一线使用贝伐珠单抗联合化疗能带来更长生存,维持治疗可延缓病情进展.与贝伐珠单抗治疗相关的不良反应较轻,患者的耐受性较好. Objective: To observe the efficacy and safety of bevacizumab combined with chemotherapy in the treatment of metastatic colorectal cancer (mCRC) .Methods: Retrospective analysis of bevacizumab in Xinjiang Tumor Hospital from January 2012 to July 2015 was retrospectively analyzed. 71 patients with mCRC combined with chemotherapy were enrolled in the study to observe their clinical efficacy and bevacizumab-related adverse reactions.At least 2 cycles of bevacizumab were evaluated after treatment and adverse reactions were recorded after each cycle.Results: 71cases of mCRC The response rate (RR) was 29.6% and the disease control rate (DCR) was 78.9% in the first-line treatment group, RR was 35.6% and DCR was 88.9% in the first-line treatment group, RR was 19.2% in the second-line treatment group, DCR was 61.5%. The median progression-free survival (mPFS) and median overall survival (mOS) of the first-line treatment group were 8.2 and 20.9 months, respectively. The mPFS and mOS were 4.4 months and 14.7 months, respectively, and mPFS was 11.7 months and 7.7 months (P <0.0001), respectively, in patients who received or did not undergo maintenance therapy after first-line chemotherapy.The adverse reactions associated with bevacizumab treatment were mainly hypertension , Proteinuria and bleeding, the vast majority of 1-2 levels. Conclusion : This study shows that bevacizumab combined with chemotherapy in patients with mCRC is benefit, first-line use of bevacizumab combined with chemotherapy can lead to longer survival, maintenance treatment can delay the progression of the disease and bevacizumab treatment The adverse reactions were mild and the patients were well tolerated.
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