贝伐单抗联合化疗治疗进展期转移性结直肠癌临床观察

Clinical research of Bevacizumab plus chemotherapy for advanced metastatic colorectal cancer

目的评价贝伐单抗联合IFL方案(伊立替康、氟尿嘧啶、亚叶酸钙)治疗进展期结直肠癌的疗效及安全性。方法回顾性总结2007年6月～2009年8月期间分别给予贝伐单抗联合IFL方案(A组,40例)和单独IFL方案(B组,37例)进行化疗患者治疗后有效率、不良反应、治疗前后肿瘤标志物的变化和随访情况。结果 A组和B组的有效率分别为40.0%和21.6%;所有患者治疗前后肿瘤标志物浓度均有明显变化(P<0.05),A组和B组比较差异具有统计学意义(P<0.05),两组不良反应为Ⅰ～Ⅱ度,无严重不良反应,且差异无统计学意义(P>0.05);A组患者1年存活率为27.5%,其中生存期(OS)最长者达15.6个月,中位疾病进展期(TTP)为4.9个月,中位OS为10.5个月。B组患者1年存活率为18.9%,其中OS最长者达12.3个月,中位TTP为3.4个月,中位OS为8.8个月。两组1年存活率、中位TTP、中位OS比较,差异均具有统计学意义(P<0.05)。结论与单独使用IFL方案相比,贝伐单抗联合化疗对于进展期转移性结直肠癌治疗具有良好的效果,多数患者不良反应为轻到中度,毒副作用发生率低,患者能够耐受,能明显延长患者的生存期。

Objective To evaluate the efficacy and safety of Bevacizumab plus chemotherapy for advanced metastatic colorectal cancer. Methods From June 2007 to August 2009, IFL program plus Bevacizumab （group A,40 cases） and IFL alone program （group B, 37 patients） were collected. Effective rate, adverse reactions, tumor markers before and after treatment and following-up situation changes were analyzed retrospectively between two groups. Results Effective rates were 40.0% and 21.6% in group A and group B. Before and after treatment, the concentration of tumor markers of all patients changed significantly （ P 〈 0. 05）, there were statistically different between two groups （ P 〈 0.05）, adverse events of two groups were Ⅰ～Ⅱ degree, no serious adverse reactions occured, the difference was not statistically significant （P 〉0.05） ; in group A, survival rate of 1 year was 27.5% , the longest survival （OS） was 15.6 months, a median period of disease progression （TTP） was 4.9 months, median OS was 10.5 months. In group B, survival rate of 1 year was 18.9% , the longest OS was 12.3 months, median TTP was 3.4 months and median OS was 8.8 months. Survival rate of 1 year, median TTP, median OS had the significant difference between two groups （P 〈 0. 05）. Conclusion Compared with IFL alone, Bevacizumab plus chemotherapy for treatment of advanced metastatic colorectal cancer has better results, the majority of adverse reactions are mild to moderate and low incidence of side effects.