贝伐珠单抗联合FOLFOX4化疗对晚期结直肠癌患者的效果

Effect of Bevacizumab Combined with FOLFOX4 Chemotherapy in Patients with Advanced Colorectal Cancer

目的研究贝伐珠单抗联合FOLFOX4[5-氟尿嘧啶(5-FU)、奥沙利铂(L-OHP)、亚叶酸钙(LV)]化疗对晚期结直肠癌(CRC)患者疗效及血清血管内皮生长因子(VEGF)、环氧化物酶-2(COX-2)水平的影响。方法选取2019年1月至2021年1月平煤神马医疗集团总医院收治的98例晚期CRC患者,按照随机数字表法分为观察组(n=49)和对照组(n=49)。对照组给予FOLFOX4化疗,观察组给予贝伐珠单抗联合FOLFOX4化疗。对比两组疗效、病灶直径、Karnofsky功能状态(KPS)评分、血清肿瘤标志物[基质金属蛋白酶-9(MMP-9)、癌胚抗原(CEA)、VEGF、COX-2、糖类抗原242(CA242)]水平及毒副反应。结果观察组客观缓解率[40.82%(20/49)]、疾病控制率[73.47%(36/49)]高于对照组[18.37%(9/49),53.06%(26/49)](P<0.05);治疗6个周期后观察组病灶直径小于对照组,KPS评分高于对照组(P<0.05);治疗6个周期后观察组血清MMP-9、CEA、VEGF、COX-2、CA242水平均低于对照组(P<0.05);两组毒副反应比较,差异无统计学意义(P>0.05)。结论贝伐珠单抗联合FOLFOX4化疗治疗晚期CRC患者疗效确切,可有效降低血清肿瘤标志物水平,促进病灶减小,提高患者生存质量。

Objective To investigate the efficacy of bevacizumab combined with FOLFOX4[5-fluorouracil(5-FU),oxaliplatin(L-OHP),leucovorin(LV)]chemotherapy in the treatment of patients with advanced colorectal cancer(CRC)and the influence of serum vascular endothelial growth factor(VEGF)and epoxidase-2(COX-2).Methods A total of 98 patients with advanced CRC admitted to General Hospital of Pingmei Shenma Medical Group from January 2019 to January 2021 were divided into observation group(n=49)and control group(n=49)according to the random number table method.The control group was given FOLFOX4 chemotherapy,and the observation group was given bevacizumab combined with FOLFOX4 chemotherapy.The efficacy,lesion diameter,Karnofsky functional status(KPS)score,serum tumor markers[matrix metalloproteinase-9(MMP-9),carcinoembryonic antigen(CEA),VEGF,COX-2,carbohydrate antigen 242(CA242)]levels and side efects.Results The objective remission rate[40.82%(20/49)]and disease control rate[73.47%(36/49)]of the observation group were higher than those of the control group[18.37%(9/49)and 53.06%(26/49)](P<0.05).After 6 cycles of treatment,the observation group’s lesion diameter was smaller than that of the control group,and the KPS score was higher than that of the control group(P<0.05).After 6 cycles of treatment,the serum levels of MMP-9,CEA,VEGF,COX-2 and CA242 in the observation group were lower than those of the control group(P<0.05).There was no statistical difference in toxicity and side effects between the two groups(P>0.05).Conclusion Bevacizumab combined with FOLFOX4 chemotherapy is effective in the treatment of patients with advanced CRC.It can effectively reduce the level of serum tumor markers,promote the reduction of lesions,and improve the quality of life of patients.