安维汀联合FOLFOX方案术前化疗对局部进展期直肠癌患者预后的影响  

Effect of Avastin combined with preoperative FOLFOX chemotherapy on the prognosis of patients with locally advanced rectal cancer

作　　者：武政喜[1] 李龙[1] 郭振海[1] 徐学明[1] 张志业[1] 李建峰[1] 鞠敏育 

机构地区：[1]宁夏石嘴山市第一人民医院普外肿瘤科,宁夏石嘴山753200 [2]宁夏石嘴山市第一人民医院检验科,宁夏石嘴山753200

出　　处：《中国生化药物杂志》2017年第5期257-259,262,共4页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的探讨安维汀（贝伐珠单抗）联合FOLFOX方案[在亚叶酸钙（CF）和5氟尿嘧啶（5-Fu）联用的基础上加用不同剂量的OXA所组成的一系列用于治疗结直肠癌的化疗方案称为FOLFOX方案]术前化疗对局部进展期直肠癌（LARC）患者预后的影响。方法将2013年1月~2016年1月医院80例择期全直肠系膜切除术（TME）的LARC患者采用随机数字表法分为对照组和观察组,各40例。对照组给予FOLFOX方案术前化疗,观察组在对照组基础上加用贝珠单抗注射液。2组均以21 d为1个化疗周期,均治疗至少4个周期,化疗后6周行遵循TEM原则行手术治疗。比较2组近远期预后、R0切除率、术后并发症发生率及化疗不良反应。结果 2组对化疗有良好反应率、R0切除率、术后并发症发生率、1年和3年生存率、1年无病生存率比较差异无统计学意义;观察组胃肠道反应、骨髓抑制发生率分别为52.5%、52.5%与对照组的25.0%、20.0%比较,差异有统计学意义（P〈0.05）,但观察组Ⅲ~Ⅳ胃肠道反应、骨髓抑制发生率分别为5.0%、15.0%与对照组的2.5%、5.0%比较差异无统计学意义;观察组3年无病生存率为82.5%高于对照组的60.0%,差异有统计学意义（P〈0.05）。结论贝伐珠单抗联合FOLFOX方案术前化疗治疗LARC可提高3年无病生存率,但不会增加术后不良反应和严重化疗不良反应。Objective To investigate the effect of Avastin （bevacizumab） combined with preoperative FOLFOX neoadjuvant chemotherapy on the prognosis of patients with locally advanced rectal cancer （LARC）.MethodsA total of 80 cases of patients with LARC treated with total mesorectal excision （TME） in our hospital from January 2013 to January 2016 were randomly divided into the control group and the observation group, 40 cases in each group.The control group were treated with preoperative FOLFOX chemotherapy while the observation group were treated with bevacizumab injection, based on the treatment in the control group.21 days was a cycle of chemotherapy, and both groups were treated for at least 4 cycles.After 6 cycles of chemotherapy, operation was carried out, following TEM principle.The short-term and long-term prognosis, rate of R0 resection, the incidence of postoperative complications and side effects of chemotherapy were compared between the two groups.ResultsThere was no significant difference between the two groups in the good response rate of chemotherapy, the rate of R0 resection, the incidence of postoperative complications, the 1-year and 3-year survival rates and 1-year disease-free survival rate.The incidence rates of gastrointestinal reactions and bone marrow suppression in the observation group were 52.5% and 52.5%, respectively while in the control group were 25.0% and 20.0%, respectively （P〈0.05）, but there was no significant difference in the incidence rates of grade Ⅲ~Ⅳ gastrointestinal reaction and bone marrow suppression between the observation group and the control group （5.0% and 15.0% vs 2.5% and 5.0%）.The 3-year disease-free survival rate of the observation group was higher than that of the control group （82.5% vs 60.0%） （P〈0.05）.ConclusionThe application of bevacizumab combined with preoperative FOLFOX chemotherapy in the treatment of LARC can improve the 3-year disease-free survival rate, without increasing postoperative adverse reactions and serious side effect

关 键 词：局部进展期直肠癌 FOLFOX方案 贝伐珠单抗 病例缓解 生存率 

分 类 号：R735.3[医药卫生—肿瘤]