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目的观察贝伐单抗和西妥昔单抗联合化疗治疗不可切除晚期结肠癌肝转移患者的疗效及安全性。方法收集2011年7月至2016年5月期间安徽省立医院经病理及影像学确诊的23例结肠癌肝转移患者资料,经评估均为不可切除。均经贝伐单抗或西妥昔单抗联合化疗,总结评估不同靶向治疗联合化疗的疗效,并对比不同部位结肠癌的疗效,回顾性分析各临床因素与预后关系。结果 23例中,5例进展,13例死亡。右半结肠10例,左半结肠13例。中位PFS(progression free survival,PFS)为7.0个月,(95%CI:4.28-9.72),中位OS(overall survival,OS)为22个月(95%CI:18.24-25.76)。单因素分析显示左半结肠较右半结肠相比PFS显著延长,差异具有统计学意义(P=0.045)。分层分析显示KRAS野生型患者中,左半结肠较右半结肠PFS显著延长,差异具有统计学意义(P=0.025)。结论对于晚期不可切除结肠癌肝转移患者,两种靶向治疗联合化疗疗效无明显差异,均安全有效,总体上左半结肠预后优于右半结肠。
Objective To observe the efficacy and safety of combination of bevacizumab and cetuximab in the treatment of unresectable patients with advanced hepatic metastasis of colon cancer. Methods The data of 23 patients with liver metastases from colon cancer who were diagnosed by pathology and imaging at Anhui Provincial Hospital from July 2011 to May 2016 were collected and were unresectable. All of them were combined with bevacizumab or cetuximab. The curative effect of different targeted therapy combined with chemotherapy was evaluated. The curative effect of different parts of colon cancer was compared. The relationship between each clinical factor and prognosis was retrospectively analyzed. Results Of 23 cases, 5 cases progressed and 13 cases died. Right colon 10 cases, left colon 13 cases. The median progression-free survival (PFS) was 7.0 months (95% CI: 4.28-9.72) and the overall survival (OS) was 22 months (95% CI: 18.24-25.76). Univariate analysis showed that PFS in the left colon was significantly longer than that in the right colon, with statistical significance (P = 0.045). Hierarchical analysis showed that PFS was significantly longer in the left colon than in the right colon in KRAS wild-type patients, with a statistically significant difference (P = 0.025). Conclusions There is no significant difference between the two kinds of targeted therapy and chemotherapy in patients with advanced hepatic metastasis of unresectable colon cancer, all of which are safe and effective. The overall prognosis of the left colon is better than that of the right colon.