贝伐珠单抗与伊立替康联合雷替曲塞二线及多线治疗晚期大肠癌的临床观察  

Clinical observation of Bevacizumab and Irinotecan combined with Raltitrexed for advanced colorectal cancer as the second-line and above treatment

作　　者：王清波[1] 李晟[2] 冯继锋[2] 朱梁军[2] 喻春钊[3] 

机构地区：[1]东南大学附属南京市第二医院肿瘤内科,江苏南京210003 [2]江苏省肿瘤医院肿瘤内科,江苏南京210009 [3]南京医科大学第二附属医院普通外科,江苏南京210011

出　　处：《中国医药导报》2015年第36期121-124,共4页China Medical Herald

基　　金：国家自然科学基金资助项目(30972910;81172269);江苏省自然科学基金资助项目(BK2011858)

摘　　要：目的 观察贝伐珠单抗与伊立替康联合雷替曲塞（IR）方案在晚期大肠癌二线及多线治疗中的效果及安全性。方法 收集2012年4月-2014年2月东南大学附属南京市第二医院及江苏省肿瘤医院肿瘤内科二线及二线以上治疗的47例晚期大肠癌患者,根据化疗方案不同将其分为两组,对照组（27例）应用IR方案,实验组（20例）应用IR联合贝伐珠单抗方案。分析比较两组患者的客观有效率（ORR）、疾病控制率（DCR）、生存时间及化疗不良反应。结果 对照组ORR为11.1%,DCR为51.9%,中位无进展生存时间（PFS）为3.5个月（95%CI：1.52-5.48）,中位总生存时间（OS）为11.9个月（95%CI：9.18-14.62）;实验组ORR为15.0%,DCR为75.0%,中位PFS为6.2个月（95%CI：3.96-8.44）,中位OS为16.2个月（95%CI：7.85-24.61）。两组ORR、DCR和OS比较差异均无统计学意义（P〉0.05）,但两组中位PFS比较差异有统计学意义（P〈0.05）。两组化疗毒副作用均较轻,差异无统计学意义（P〉0.05）。结论 IR方案在晚期大肠癌二线及二线以上治疗中有一定疗效,毒副作用可耐受,加用贝伐珠单抗后生存获益可能更明显,值得临床进一步研究。Objective To observe the efficacy and safety of Bevacizumab and Irinotecan combined with Rahitrexed （IR） regimen as second-line or above treatment for advanced colorectal cancer. Methods Forty seven patients with ad- vanced colorectal cancer admitted to Department of Medical Oncology in the Second Hospital of Nanjing Affiliated to Southeast University and Jiangsu Cancer Hospital from April 2012 to February 2014 were collected and divided into two groups according to the different chemotherapy regimens. The control group （27 cases） received IR regimen, the ex- perimental group （20 cases） were given IR combined with Bevacizumab regimen. The objective response rate （ORR）, disease control rate （DCR）, surAval time and chemotherapy side effects between the two groups were analyzed and compared. Results In the control group, ORR was 11.1%, DCR was 51.9%, the median progression free survival （PFS） was 3.5 months （95%CI： 1.52-5.418）, the median overall survival （OS） was 11.9 months （95%CI： 9.18-14.62）; in the ex- perimental group, ORR was 15.0%, DCR was 75.0%, the median PFS was 6.2 months （95%CI： 3.96-8.44）, the median OS was 16.2 months （95%CI： 7.85--24.61）. There were no statistically significant differences of ORR, DCR and OS between the two groups （P 〉 0.05）, while there was a statistically significant difference of median PFS between the two groups （P 〈 0.05）. The adverse reactions of both groups were hght, there was no statisticaUy significant difference in the two groups （P 〉 0.05）. Conclusion IR is an effective and well-toierated chemotherapy regimen as second-line or above treatment for advanced colorectal cancer, and the survival benefit is more obvious after adding with Bevacizumab, which is worthyof clinical further study.

关 键 词：贝伐珠单抗 伊立替康 雷替曲塞 晚期大肠癌 

分 类 号：R735.3[医药卫生—肿瘤]