贝伐珠单抗治疗老年胃肠肿瘤患者的疗效观察

Clinical observation of bevacizumab combined with chemotherapy in elderly patients with gastrointestinalneoplasms

目的观察贝伐珠单抗联合化疗治疗老年胃肠肿瘤的近期疗效和不良反应。方法对64例老年胃肠肿瘤患者化疗联合贝伐单抗治疗的临床资料进行分析，临床随机分为观察组和对照组各33例，两组患者均采用希罗达联合奥沙利铂（XELOX）方案进行治疗，每21周为1周期。观察组额外使用贝伐珠单抗7．5mg／kg，周期同观察组。根据WHO近期疗效标准和WHO抗癌药物急性与亚急性不良反应表现和分度标准进行客观疗效评价和不良反应评定。结果64例老年胃肠肿瘤患者中，观察组总有效率68．8％，疾病控制率为87．5％；对照组总有效率43．8％，疾病控制为78．1％。观察组患者不良反应中，白细胞减少、血红蛋白下降、消化道反应的发生率均小于对照组，血小板减少的发生率观察组高于对照组，但差异均无统计学意义。观察组中无Ⅳ期不良反应发生。结论贝伐珠单抗联合化疗治疗老年胃肠肿瘤患者近期疗效明显，不良反应患者可耐受，安全有效，适合临床推广使用。

Objective To investigate the clinical efficacy and toxicity of bevacizumab combined with chemotherapy in elderly patients with gastrointestinal neoplasms. Methods A total of 64 elderly patients with gastrointestinal neoplasms were selected. The clinical data of patients treated with chemotherapy or chemotherapy plus bevacizumab were analyzed. Patients were randomly divided into the observation group and the control group （n 32, each）. The observation group was treated with bevacizumab （7.5 mg/kg） in combination with XELOX （OXA＋Xeloda）, and the control group was treated with XELOX only （21 weeks as a cycle）. The clinical efficacy and toxicity of bevacizumab were evaluated according to WHO short-term efficacy standards and standards of anticancer drugs in acute or subacute adverse reactions. Results In observation group, complete remission was found in 4 cases, partial response in 18 cases, stable disease in 6 cases, progressive disease in 4 cases, and the total efficiency was 68.8%. In control group, partial response was found in 14 cases, stable disease in 11 cases, progressive disease in 7 cases, and the total efficiency was 43.8%. The incidences of leucopenia, hemoglobin desaturation and gastrointestinal reactions were lower and the incidence of thrombocytopenia was higher in observation group than in control group, which had no significant differences between the 2 groups. Phase IV toxicity was not found in observation group. Conclusions Bevacizumab combined with chemotherapy is safe and effective for elderly patients with gastrointestinal neoplasms. Most patients can tolerate the side effects. It is worth promoting in clinical medicine.