贝伐珠单抗联合卡培他滨维持对晚期结肠癌患者预后的影响

The Impact of Bevacizumab Combined with Capecitabine Maintenance on the Prognosis of Patients with Advanced Colorectal Cancer

目的:探究贝伐珠单抗联合卡培他滨维持对晚期结肠癌患者预后的影响。方法:收集2017年1月至2019年1月期间我院101例晚期结肠癌患者的病例资料,所有患者均接受5-氟尿嘧啶及卡培他滨为基础的贝伐珠单抗联合mFOLFOX6或XELOX化疗一线化疗方案,其中42例患者一线化疗后接受卡培他滨单药维持治疗,纳入对照组,59例患者接受贝伐珠单抗联合卡培他滨维持治疗,纳入观察组,两组治疗均直至病情进展或毒副反应无法耐受。比较两组患者维持治疗时间和疾病控制时间,治疗前后Karnofsky功能状态评分(KPS)、美国东部肿瘤协作组体力状态评分(ZPS),血清肿瘤标志物水平,毒副反应以及远期预后情况。结果:观察组维持治疗时间、疾病控制时间均大于对照组(P<0.05);两组KPS均较治疗前升高,ZPS均较治疗前降低,观察组变化幅度均大于对照组(P<0.05);两组血清癌胚抗原(CEA)、唾液酸化盐藻戊糖(CA199)、胃癌抗原(CA724)水平均较治疗前降低,观察组变化幅度均大于对照组(P<0.05);两组毒副反应发生情况差异无统计学意义(P>0.05);观察组总生存率高于对照组(P<0.05)。结论:晚期结肠癌一线治疗后贝伐珠单抗联合卡培他滨维持治疗安全有效,可延长生存时间,同时不良反应轻微。

Objective:To explore the impact of bevacizumab combined with capecitabine maintenance on the prognosis of patients with advanced colorectal cancer.Methods:Clinical data of 101 patients with advanced colorectal cancer treated in our hospital from January 2017 to January 2019 were collected.All patients received first-line chemotherapy based on 5-fluorouracil and capecitabine,combined with bevacizumab and mFOLFOX6 or XELOX regimen.Among them,42 patients received capecitabine monotherapy maintenance treatment after first-line chemotherapy(control group),and 59 patients received bevacizumab combined with capecitabine maintenance treatment(observation group).Both groups were treated until disease progression or intolerable toxic reactions.The maintenance treatment time,disease control time,Karnofsky Performance Status(KPS),Eastern Cooperative Oncology Group performance status(ZPS),serum tumor marker levels,adverse reactions,and long-term prognosis were compared between the two groups.Results:The maintenance treatment time and disease control time in the observation group were both longer than those in the control group(P<0.05).Both groups showed an increase in KPS and a decrease in ZPS after treatment,and the change in the observation group was greater than that in the control group(P<0.05).The serum levels of CEA,CA199,and CA724 in both groups decreased compared to before treatment,and the change in the observation group was greater than that in the control group(P<0.05).There was no statistically significant difference in the occurrence of adverse reactions between the two groups(P>0.05).The overall survival rate in the observation group was higher than that in the control group(P<0.05).Conclusion:Bevacizumab com-bined with capecitabine maintenance treatment after first-line treatment for advanced colorectal cancer is safe and effective,prolonging survival time with mild adverse reactions.