贝伐单抗联合化疗治疗晚期结直肠癌的临床观察  

Clinical observation of bevacizumab plus chemotherapy for advanced colorectal cancer

作　　者：赵静[1] 张文[1] 李文桦[1] 朱丹[1] 

机构地区：[1]复旦大学附属肿瘤医院肿瘤内科,复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中国癌症杂志》2011年第10期799-802,共4页China Oncology

摘　　要：背景与目的:贝伐单抗(bevacizumab,BV)是抗血管内皮生长因子(vascular endothelialgrowth factor,VEGF)的人源化单抗,与化疗药物联用于治疗复发转移性结直肠癌,可明显改善疗效和生存期,不良反应可耐受。本文旨在观察贝伐单抗联合化疗治疗晚期结直肠癌的疗效及不良反应。方法:46例经病理组织学证实的晚期结直肠癌患者均接受贝伐单抗联合化疗治疗,贝伐单抗的剂量采用美国国立综合癌症网络(NCCN)推荐的5 mg/kg,每2周重复,或7.5 mg/kg,每3周重复。每2～3个疗程后评价疗效,同时观察并记录不良反应。结果:所有患者中,PR9例,SD30例,PD7例。客观有效率为20%,疾病控制率为85%。中位无进展生存期6.0个月,中位总生存期9.3个月。一线、二线、三线及以上应用贝伐单抗客观有效率分别为35%、6%和17%,疾病控制率分别为82%、88%和83%,中位无进展生存期分别为8.6、5.2和6.3个月,中位总生存期分别为12.2、8.3及8.1个月。不良反应为高血压3例,尿隐血阳性2例,蛋白尿1例,阴道出血1例,痰中带血1例,鼻衄1例,均为1～2级,对症治疗后均缓解:7例患者出现3～4级骨髓抑制,未出现粒缺性发热;2例患者因出现持续性2～4级肝功能受损未继续抗癌治疗。结论:贝伐单抗联合化疗治疗晚期结直肠癌的临床获益较肯定,且不良反应轻,患者耐受性较好,但需监测肝功能及血常规变化。Background and purpose：Bevacizumab（BV）is a humanized monoclonal antibody for vascular endothelial growth factor（VEGF）,which is used with chemotherapy for patients with recurrent and metastatic colorectal cancer,and it can significantly improve the efficacy and survival,with tolerable adverse reactions.This study aimed to evaluate the efficacy and adverse effects of bevacizumab in treating advanced colorectal cancel.Methods：Forty-six patients with advanced colorectal cancer were treated with bevacizumab combined with chemotherapy.Bevacizumab was given with 5mg/kg every two weeks,or 7.5mg/kg every 3 weeks.Efficacy was evaluated every 2 to 3 cycles, and adverse effects were abserved and reccorded.Results：Nine of 46 patients had partial response and 30 patients had stable disease and 7 patients had progressive disease.The response rate was 20%and the disease control rate was 84.8%.The progress-free survival was 6.0 months and the median overall survival time were 9.3 months.The response rates of bevacizumab for first-,second- and third- or more line were 35%,6%and 17%,the disease control rate were 82%,88%and 83%respectively,PFS were 8.6,5.2 and 6.3 months,and OS were 12.2,8.3 and 8.1 months respectively. The adverse events related to bevacizumab were hypertension in 3 patients,positive urine occult blood in 2 patients, colporrhagia in 1 patient,bloody phlegm in 1 patient,hemorrhinia in 1 patient,and all adverse effects were grade 1 or 2; 7 patients had grade 3 or 4 myelosuppression,and 2 patients stopped anti-cancer therapy because of persistent damaged liver function.Conclusion：The combination of bevacizumab plus chemothepy has definite clinical benefits in patients with mCRC,and it can be used as first-line,second-line or later therapy.The adverse effects are mild and well tolerated, but liver function and hemogram change need monitoring.

关 键 词：贝伐单抗 药物疗法 晚期结直肠肿瘤 

分 类 号：R735.35[医药卫生—肿瘤] R735.37[医药卫生—临床医学]