贝伐珠单抗联合化疗治疗难治性实体瘤的疗效和安全性

The Clinical Observation of Bevacizumab Combined with Chemotherapy for Refractory Advanced Solid Tumors

目的：研究含安维汀的联合化疗方案在晚期难治性实体瘤中的疗效及安全性。方法：2011年10月-2012年9月，53例晚期实体肿瘤患者接受安维汀联合化疗方案治疗。安维汀用法为7.5 mg/kg静滴，d1；依据肿瘤类型和既往治疗史选择化疗方案。所有方案均以3周为一周期。结果：53例晚期实体肿瘤患者随访1-12个月，在50例可评价病例中，PR23例、SD18例、PD9例，有效率为46.0%，疾病控制率为82.0%；中位无疾病进展时间（PFS）为5.4个月（95%CI：3.704~6.913个月），中位生存时间（OS）为10.9个月（95%CI：9.255-14.830个月）。常见毒副反应为：骨髓抑制、疲劳或乏力、腹泻和腹痛、高血压等，3~4级毒副反应以中性粒细胞减少16.0%（8/50），腹泻12.0%（6/50），疲乏10.0%（5/50），高血压8.0%（4/50）为主。严重不良反应累积发生率为20.0%（10/50），最常见的为肺炎和腹痛，室上性心动过速分别均为4.0%（2/50）。脱水、腹泻、粒缺性发热、败血症为2.0%（1/50）。结论：贝伐单抗联合不同化疗方案治疗既往多次化疗的难治性晚期实体肿瘤安全有效。

Objective：To determine the safety and efficacy of bevacizumab in combination with different chemotherapy regimens for second-line and second-line above treatment of refractory advanced solid tumors. Method：From October 2011 to september 2012, fifty three patients were enrolled. The dose of bevacizumab was 7.5 mg/kg ,iv drip,d1. The chemotherapy regimens were chosen depending on the type of tumor and the past medical history. All the plans with 3 weeks for a cycle. Result：53 patients with advanced solid tumors were followed up for 1-12 months, 50 cases could be evaluated：PR were 23 cases, SD were 18 cases, PD were 9 cases, the effective rate was 46.0%, the disease control rates was 82.0%;PFS was 5.4 months（95%CI：3.704-6.913 months）, OS was 10.9 months（95%CI：9.255-14.830 months）.The common adverse reaction were：the bone marrow suppression, fatigue, diarrhea and abdominal pain, hypertension, etc.;3-4 adverse reaction were：neutropenia 16.0%（8/50）, diarrhea 12.0%（6/50）, fatigue 10.0%（5/50）, hypertension, 8.0%（4/50）. The cumulative incidence of serious adverse events was 20.0%（10/50）, the most common for pneumonia and abdominal pain, SVT were 4.0%（2/50）respectively;dehydration, diarrhea, lack of sexual fever, sepsis were 2.0%（1/50）respectively. Conclusion：Bevacizumab in combination with different chemotherapy regimen in treatment for late refractory solid tumors is safe and effective.