贝伐单抗二线治疗转移性结直肠癌的临床观察

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。

The Clinical Observation of Bevacizumab in the Second-line Treatment of Patients with Metastatic Colorectal Cancer

Objective: To investigate the clinical efficiency and toxicity of bevacizumab on the second-line treatment of patients with metastatic colorectal cancer.Methods: From August,2008 to October,2011,retrospective analysis of 21 cases with metastatic colorectal cancer were performed.All the diagnosis were confirmed by histopathology.Patients were treated with bevacizumab 5mg/kg every 2 to 3 weeks combined with irinotecan-based and oxaliplatin-based chemotherapy regimens after failure of the first-line treatment.The therapy effect and toxicity were evaluated after every two to three cycles.Results: In these 21 cases,the cases of PR,SD,PD were 1,11 and 9,the ORR(objective response rate) and DCR(disease control rate) were 4.8% and 57.1% and the mediant TTP(time to progression) was 3.7 months.The mainly adverse reactions of these patients were marrow suppression,exanthems,nausea and vomiting,diarrhea,liver damage and neurotoxicity.The incidence of bevacizumab-induced hypertension and epistaxis were 14.3%(3/21)and 4%(2/21).Conclusion: The therapy effect of bevacizumab in the second-line treatment after the progression in patients with metastatic colorectal cancer was limited.The toxicity could be acceptable.