目的:观察贝伐单抗二线治疗转移性结直肠癌患者的临床疗效和毒副反应。方法:回顾性分析2008年8月至2011年10月我院经组织病理学证实的转移性结直肠癌患者21例,一线治疗进展后,二线治疗方案中加用贝伐单抗,用法为5mg/kg,每2-3周1次,与化疗方案同步。化疗方案以奥沙利铂及伊立替康为基础,完成2-3周期治疗后评定疗效,观察毒副反应。结果:21例患者中PR1例,SD11例,PD9例,客观缓解率为4.8%,疾病控制率为57.1%,中位TTP为3.7个月。患者出现的不良反应有骨髓抑制、皮疹、恶心呕吐、腹泻、肝功能损害、神经毒性等,贝伐单抗所致高血压的发生率为14.3%(3/21),鼻衄发生率为4%(2/21)。结论:二线治疗中使用贝伐单抗,对一线治疗进展后的转移性结直肠癌疗效有限,毒副反应可耐受。 Objective: To observe the clinical efficacy and side effects of bevacizumab in second-line treatment of patients with metastatic colorectal cancer. Methods: Twenty-one patients with metastatic colorectal cancer confirmed by histopathology in our hospital from August 2008 to October 2011 were retrospectively analyzed. After first-line treatment, bevacizumab was added to the second-line treatment and the usage was 5 mg / kg, once every 2-3 weeks, synchronized with the chemotherapy regimen. The chemotherapy regimen is based on oxaliplatin and irinotecan, and the curative effect is evaluated after 2-3 cycles of treatment, and the side effects are observed. Results: Among the 21 patients, PR1, SD11 and PD9 showed objective response rate of 4.8%, disease control rate of 57.1% and median TTP of 3.7 months. Adverse reactions in patients with bone marrow suppression, rash, nausea and vomiting, diarrhea, liver damage, neurotoxicity, the incidence of bevacizumab-induced hypertension was 14.3% (3/21), the incidence of epistaxis 4 % (2/21). CONCLUSIONS: Bevacizumab in second-line therapy has limited efficacy in metastatic colorectal cancer after first-line therapy and is tolerant of toxic and side effects.