贝伐珠单抗联合FOLFIRI方案治疗晚期转移性结直肠癌患者的临床观察

Clinical Observation on Bevacizumab Combined with FOLFIRI for Metastatic Colorectal Cancer

目的:观察贝伐珠单抗联合化疗治疗晚期转移性结直肠癌患者的近期疗效和毒副反应。方法:回顾性分析38例晚期转移性结直肠癌患者贝伐珠单抗联合FOLFIRI方案治疗的临床资料,化疗应用4～6个周期,贝伐珠单抗应用直至病情进展。治疗过程中据NCI CTC 3.0版本评价不良反应级别。结果:38例结直肠癌患者中,一线治疗25例,CR 2例,PR 12例,SD 3例,PD 8例,有效率56.0%,疾病控制率68.0%,中位PFS 11.3个月;二线治疗13例,PR 5例,SD 2例,PD 6例,有效率38.5%,疾病控制率53.8%,中位PFS 9.5个月,两组有效率及中位无进展生存(PFS)时间有统计学差异(P<0.O5)。38例患者常见不良反应为1或2级的鼻衄、咯血、高血压、蛋白尿等,程度均较轻可以耐受。结论:贝伐殊单抗联合化疗治疗晚期转移性结直肠癌患者近期疗效好,其毒副反应患者可耐受,远期疗效有待进一步的研究。

Objective： To investigate the therapeutic efficacy and toxicity of bevacizumab combined with FOLFIRI chemothera py in patients with metastatic colorectal cancer. Methods： Thirtyeight patients with metastatic eolorectal cancer were treated with beva eizumab combined with FOLFIRI for 4 cycles to 6 cycles. Bevacizumab was used until progressive disease （PD）. Results： Of the 25 pa tients who received the firstline treatment, 2 achieved complete remission （CR）, 12 achieved partial responses （PR）, 3 had stable dis ease （SD）, and 8 had progressive disease （PD）, with a risk ratio （RR） of 56.0% and a disease control rate （DCR） of 68.0%. The median progressionfree survival （PFS） was 11.3 months. Of the 13 who received the secondline treatment, 0 achieved complete remission, 5 had PR, 2 had SD, and 6 had PD, resulting in an RR of 38.5% and DCR of 53.8%. The median PFS was 9.5 months. Significant differ ences in total effectivity rate and median PFS were observed between the two groups （P 〈 0.05）. The major toxicities/adverse events were epistaxis, hemoptysis, hypertension, and proteinuria, which were not severe and were well tolerated. Conclusion： Bevacizumab combined with FOLFIRI chemotherapy is effective for patients with metastatic colorectal cancer. Most patients tolerate the side effects of this combined treatment. Further studies are necessary to determine the longterm effects of the combined bevacizumabFOLFIRI treatment.