贝伐珠单抗联合化疗治疗复治转移性结直肠癌的疗效观察  

Clinical Efficacy of Bevacizumab Combined with Chemotherapy in the Treatment of Refractory Metastatic Colorectal Cancer

作　　者：张秀凤[1] 顾人东[1] 石燕[2] 茅慧[2] 陈杨[2] 陈丽[2] 戴广海[2] ZHANG Xiu-feng;GU Ren-dong;SHI Yan;MAO Hui;CHEN Yang;CHEN Li;DAI Guang-hai(Department of Oncology Rizhao Hospital of TCM,Rizhao 276800,China;Department of Internal Medicine-Oncology China PLA General Hospital,Beijing 100853,China)

机构地区：[1]日照市中医医院肿瘤科,山东日照276800 [2]中国人民解放军总医院肿瘤内科,北京100853

出　　处：《临床药物治疗杂志》2014年第S01期28-31,34,共5页Clinical Medication Journal

摘　　要：目的:观察贝伐珠单抗(bevacizumab,Bev)联合化疗治疗复治转移性结直肠癌(mCRC)的疗效和不良反应。方法:回顾分析2010年1月-2013年12月在解放军总医院接受Bev联合化疗二线及以上治疗的mCRC 60例。采用实体肿瘤疗效评价标准(RECIST)1.0版评价疗效,Kaplan-Meier法进行生存分析。结果:60例mCRC,9例部分缓解(PR),36例稳定(SD),客观缓解率(ORR)为15%,疾病控制率(DCR)为75.0%。二线治疗的39例中PR 5例,SD 23例,ORR 12.8%,DCR 71.8%。三线治疗的28例中PR 4例,SD 16例,ORR 14.3%,DCR 71.4%。三线以上治疗的9例中PR 0例,SD 6例,DCR 66.7%。二线治疗的中位无进展生存期(mPFS)及总生存(mOS)分别为3.4月和10.2月;三线及三线以上治疗的mPFS分别为4.8月和2.8月,mOS分别为9.4月和10.9月。Bev相关不良反应包括蛋白尿、出血、高血压,均为1~2级。结论:Bev联合化疗三线及三线以上治疗mCRC展现了较好的疾病控制率及生存获益,且在初次Bev治疗进展后更改化疗方案继续使用Bev仍可临床获益。多线及后线应用Bev联合化疗并未增加不良反应发生率,不良反应可耐受其发生机制尚不明确,多种危险因素可使其发生风险增加,临床中应注意对高危患者的识别和管理。Objective:To investigate the efficacy and toxicity of bevacizumab combined with chemotherapy for patients with refractory metastatic colorectal cancer(mCRC)as second-or later-line treatment.Methods:Sixty patients with mCRC treated by bevacizumab combined with chemotherapy in the PLA General Hospital from January 2010 to December 2013 were retrospectively analyzed with their overal response rate(RR),disease control rate(DCR),progression-free survival(PFS)and overal survival(OS).The tumor responses were assessed by response evaluation criteria in solid tumors guidelines(RECIST)version1.1.The adverse reactions were evaluated by common terminology criteria for adverse events version 3.0.The survival analysis was made by Kaplan-Meier method.Results:Of 60 patients with mCRC,9 patients achieved partial response(PR)and 36 patients had stable disease(SD),exhibited an RR of 15.0%,and a DCR of 75.0%.Of 39 mCRC patients in second-line treatment by chemotherapy combined with bevacizumab,PR:5,SD:23 patients,ORR:12.8%and DCR:71.8%.In the third-line treatment,4 of 28 patients were PR,16 patients were SD,ORR:14.3%,DCR:71.4%.In the later-line treatment,there was no PR,just 6 patients were SD,DCR:66.7%.The median DFS and OS in the second-line treatment were 3.4 and 10.2 months respectively.In the third-and later-line treatment,the median DFS were 4.8 and 2.8 months respectively,the median OS were 9.4 and 10.9 months,respectively.The adverse events related to bevacizumab included proteinuria,hemorrhage and hypertension,which were mostly in grade l-2 and aleviated with drug treatment.Conclusion:The efifcacy of Bevacizumab in combination with chemotherapy as second-line therapy for mCRC has not been improved signiifcantly,but the use of bevacizumab in the three line and three line above treatment can obtain better disease control rate and survival beneift.Patients who received bevacizumab combined with chemotherapy at the ifrst time can achieve beneift by changing chemotherapy regimen only after PD.Multi-line and the later-line applic

关 键 词：贝伐珠单抗 化疗 转移性结直肠癌 

分 类 号：R978.7[医药卫生—药品] R512.62[医药卫生—药学]