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目的观察重组人血管内皮抑素(恩度)联合化疗药物治疗转移性结直肠癌的近期疗效和安全性。方法应用恩度联合5-氟尿嘧啶类、奥沙利铂、伊立替康为基础的化疗方案治疗转移性结直肠癌患者32例,采用RECIST1.1版评价疗效,应用NCI CTC 3.0版评价不良反应,用Kaplan-Meier法进行生存分析。结果 32例患者平均接受恩度联合化疗治疗4.4个周期,29例患者可评估疗效,其中部分缓解(PR)12例,疾病稳定(SD)9例,疾病进展(PD)8例,有效率(RR)为41.4%(12/29),疾病控制率(DCR)为72.4%(21/29)。一线治疗患者14例,RR 57.1%(8/14),DCR 85.7%(12/14)。2例患者肝转移病灶由潜在可切除变为可切除病灶,并成功接受了肝转移灶的R0切除术。二线治疗患者11例,RR 36.4%(4/11),DCR 72.7%(8/11)。获随访的29例患者中位无进展生存期(PFS)7.1个月。所有患者均可进行不良反应评估,化疗的主要不良反应为骨髓抑制和胃肠道反应,多为1~2级;与恩度相关的不良反应主要为心血管系统毒性,2例患者出现心电图异常改变。结论恩度联合化疗治疗转移性结直肠癌的近期疗效较好,不良反应可耐受,具有一定的临床应用推广价值。
Objective To observe the short-term efficacy and safety of recombinant human endostatin (Endostar) combined with chemotherapy in the treatment of metastatic colorectal cancer. Methods 32 cases of patients with metastatic colorectal cancer were treated with Endo combined with 5-fluorouracil, oxaliplatin and irinotecan-based chemotherapy. RECIST1.1 was used to evaluate the curative effect. NCI CTC version 3.0 was used to evaluate the adverse reactions, Survival analysis was performed using Kaplan-Meier method. RESULTS: Thirty-two patients received an average of 4.4 cycles of Endostar combined with chemotherapy. Twenty-nine patients were evaluated for efficacy. Among them, partial remission (PR) was 12, stable disease (SD) was 9, and disease progression (PD) RR) was 41.4% (12/29), and the disease control rate (DCR) was 72.4% (21/29). The first-line treatment of 14 patients, RR 57.1% (8/14), DCR 85.7% (12/14). Two cases of liver metastases from potentially resectable into resectable lesions, and successfully accepted the liver metastases R0 resection. In the second-line treatment group, 11 patients had RR 36.4% (4/11) and DCR 72.7% (8/11). The 29 patients who were followed had a median progression-free survival (PFS) of 7.1 months. All patients can be adverse reaction assessment, the main adverse reactions of chemotherapy for bone marrow suppression and gastrointestinal reactions, mostly in 1 to 2; adverse reactions associated with Endood mainly cardiovascular system toxicity, 2 patients with ECG abnormalities change. Conclusions Endood combined with chemotherapy for metastatic colorectal cancer has good curative effect in the near future and adverse reactions can be tolerated. It has certain clinical application value.