贝伐珠单抗联合化疗治疗结直肠癌肝转移的疗效观察

Efficacy of bevacizumab combined with chemotherapy for liver metastasis from colorectal cancer

目的探讨贝伐珠单抗(BV)联合化疗治疗结直肠癌肝转移的临床疗效。方法选取2013年3月至2015年3月间济宁医学院附属医院湖西医院收治的86例结直肠癌肝转移患者,按入院时间随机分为观察组和对照组,每组43人。对照组患者采用奥沙利铂+亚叶酸钙+氟尿嘧啶(FOLFOX方案)化疗,观察组患者采用BV联合FOLFOX方案化疗。结果观察组疾病控制率高于对照组患者,差异有统计学意义(P<0.05)。两组患者严重不良反应发生率比较,差异无统计学意义(P>0.05)。观察组患者无进展生存时间高于对照组患者,差异有统计学意义(P<0.05)。观察组患者1年和2年生存率均高于对照组患者,差异有统计学意义(均P<0.05);两组患者3年生存率比较,差异无统计学意义(P>0.05)。治疗后,观察组患者上升时间(RT)和平均渡越时间(mTT)均显著升高,差异均有统计学意义(均P<0.05),而对照组的RT和mTT并无显著变化,差异无统计学意义(P>0.05),且观察组在不同检测时间点RT和MTT均高于对照组,差异均有统计学意义(均P<0.05)。结论 BV联合化疗治疗结直肠癌肝转移,可延长患者无进展生存时间,提高1年及2年生存率;超声造影定量参数RT和MTT可用来评估结直肠癌肝转移患者的早期疗效。

Objective To study the clinical efficacy of bevacizumab combined with chemotherapy for liver metastasis from colorectal cancer. Methods From March 2013 to March 2015,86 patients with liver metastasis from colorectal cancer who were treated at Jining Medical College Affiliated Huxi Hospital were included in the study. According to the adimission sequence,patients were divided into an observation group and a control group with 43 patients in each group. The observation group received bevacizumab combined with 5-fluorouracil and oxaliplatin（FOLFOX） chemotherapy and the control group only received FOLFOX. Results The disease control rate was higher in the observation group than in the control group（P〈0. 05）. There was no significant difference in the incidence of serious adverse reactions between the observation group and the control group（P〉0. 05）. The progression free survival（PFS） was higher in the observation group than in the control group（P〈0. 05）. The 1-and 2-year survival rate was higher in the observation group than in the control group（P〈0. 05）. There was no statistically significant difference in the3-year survival rate between the two groups（P〉0.05）. After the treatment,the rise time（RT） and mean transit time（mTT） significantly increased in the observation group and no change was found in the control group（P〈0. 05）. RT and mTT at each time point were significantly higher in the observation group than in the control group（P〈0. 05）. Conclusion Bevacizumab combined with FOLFOX prolongs the PFS and increase the 1-and 2-year survival period in patients with liver metastasis from colorectal cancer. RT and mTT,quantitative parameter of contrast-enhanced ultrasound,can be used to evaluate the early efficacy in liver metastasis from colorectal cancer.