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目的总结贝伐珠单抗联合化疗治疗晚期结直肠癌的临床疗效和安全性。方法 86例经病理证实的晚期结直肠癌患者接受以奥沙利铂、5-氟尿嘧啶、伊立替康等为基础的化疗联合贝伐珠单抗治疗。贝伐珠单抗治疗2~3个周期后评价疗效和相关不良反应。结果 86例中,部分缓解20例、疾病稳定49例、疾病进展17例,总客观缓解率(ORR)23.3%(20/86),疾病控制率(DCR)80.2%(69/86)。其中,贝伐珠单抗联合一线化疗46例,二线化疗27例,三线化疗13例。其ORR分别为32.6%、18.5%和0,DCR分别为87.0%、74.1%和69.2%,中位疾病无进展生存期分别为9.1、5.0和4.4个月,中位总生存期分别为19.2、10.0和8.9个月。常见的不良反应包括白细胞减少、血小板减少、恶心、呕吐、腹泻、高血压和蛋白尿等。结论贝伐珠单抗联合化疗治疗晚期结直肠癌有较好的临床疗效,相关不良反应较轻。
Objective To summarize the clinical efficacy and safety of bevacizumab combined with chemotherapy in the treatment of advanced colorectal cancer. Methods Eighty-six patients with pathologically confirmed advanced colorectal cancer underwent chemotherapy combined with bevacizumab based on oxaliplatin, 5-fluorouracil and irinotecan. Bevacizumab treatment after 2 to 3 cycles evaluation of efficacy and related adverse reactions. Results Among the 86 cases, 20 cases were partially relieved, 49 cases were stable, 17 cases were progressive. The total objective response rate (ORR) was 23.3% (20/86) and the disease control rate was 80.2% (69/86). Among them, bevacizumab combined with first-line chemotherapy in 46 cases, second-line chemotherapy in 27 cases, 13 cases of third-line chemotherapy. The ORRs were 32.6%, 18.5%, and 0 respectively. The DCRs were 87.0%, 74.1% and 69.2% respectively. The median progression-free survival rates were 9.1, 5.0 and 4.4 months, respectively. The median overall survival was 19.2% 10.0 and 8.9 months. Common adverse reactions include leukopenia, thrombocytopenia, nausea, vomiting, diarrhea, high blood pressure and proteinuria. Conclusion Bevacizumab combined with chemotherapy for advanced colorectal cancer have better clinical efficacy, with less adverse reactions.