贝伐单抗相关性高血压预测转移性结直肠癌疗效的临床研究

Bevacizumab-related hypertension in predicting the efficacy of bevacizumab in treatment for metastatic colorectal cancer

目的探讨贝伐单抗相关性高血压在预测转移性结直肠癌(mCRC)疗效中的作用。方法回顾性研究,选取2011年1月至2014年12月在首都医科大学附属北京友谊医院治疗的107例mCRC患者,所有患者均应用含有贝伐单抗的方案进行治疗。在基线期及每次治疗前记录患者血压,观察患者高血压的发生率,以及发生高血压患者与未发生高血压患者相比疾病控制率(DCR)、无进展生存期(PFS)及总生存期(OS)的差异。结果107例应用含有贝伐单抗方案进行治疗的mCRC患者中,发生高血压22例(20.5%),22例患者中发生3级高血压5例(4.6%),无4~5级高血压病例。中位随访时间为18.2个月,应用贝伐单抗进行治疗的患者中,发生高血压的患者比未发生高血压的患者疾病控制率更高(75.3%vs.50.0%,P=0.021),无进展生存期更长(12.7个月vs.10.1个月,P=0.016),总生存期更长(22.5个月vs.19.5个月),但差异均无统计学意义(P=0.082)。结论在应用含有贝伐单抗方案治疗的mCRC患者中,高血压的发生可能是患者临床获益的预测因子。

Objective To investigate the role of Bevacizumab-related hypertension in predicting the efficacy of Bevacizumab in treatment for metastatic colorectal cancer (mCRC). Methods A total of 107 patients with mCRC who were treated at the Beijing Friendship Hospital,Capital Medical University from January 2011 to December 2014 were enrolled in this retrospective study. All patients were treated with a treatment regimen containing bevacizumab. Patients' blood pressure was recorded at baseline and before each treatment. The incidence of hypertension in patients,and calculate the difference between disease control rate (DCR),progression-free survival (PFS),and overall survival (OS) in patients with hypertension compared with those without hypertension were observed. Results In 107 patients with mCRC who were treated with the bevacizumab,22 (20.5%) developed hypertension,5 (4.6%) developed grade 3 hypertension in these 22 patients,and no grade 4-5 hypertension occurred. The median follow-up time was 18.2 months. Patients with hypertension after treatment with Bevacizumab had higher disease control rate (DCR) than those without hypertension (75.3% vs. 50.0%, P =0.021),and progression-free survival was longer (12.7 months vs. 10.1 months, P =0.016). Overall survival had a prolonged trend (22.5 months vs. 19.5 months),but did not reach statistical significance ( P =0.082). Conclusion Bevacizumab-related hypertension may be a predictor of clinical benefit of Bevacizumab in treatment for metastatic colorectal cancer.