贝伐珠单抗联合一线化疗晚期转移性结直肠癌的临床观察

目的：观察贝伐珠单抗联合一线化疗对晚期结直肠癌（metastatic colorectal cancer， mCRC）的疗效和毒副作用。方法30例经组织或细胞病理学证实的 mCRC 患者接受贝伐珠单抗与一线化疗药物联合治疗。贝伐珠单抗剂量为5 mg／kg 每2周重复，或7．5 mg／kg 每3周重复。一线化疗方案：18例联合 L-OHP 为主方案（FOLFOX 方案或者 CapeOx 方案），12例联合 CPT-11为主方案（FOLFIRI方案）。评估疗效和不良反应并随访生存信息。结果30例中无 CR 患者，PR 15例（50．0％），SD 10例（33．3％），PD 5例（16．7％）；客观有效率50．0％，疾病控制率83．3％；中位无进展生存时间为10．809个月（95％CI：4．079～15．921）。贝伐珠单抗相关不良反应主要为高血压3例、鼻衄1例、蛋白尿1例。另有2例出现血液性毒性，考虑和化疗相关，接受 CPT-11方案者中4例出现迟发型腹泻。但上述副反应程度较轻，经对症处理后均可缓解，未影响治疗。结论贝伐珠单抗联合一线化疗对 mCRC 的疗效确切，不良反应发生率低、程度较轻，患者耐受性可，是mCRC一线治疗的理想选择。

Evaluation of Bevacizumab combined with chemotherapy for the first-line treatment on patients with metastatic Colorectal Cancer

Objective To evaluate the efficacy and safety of Bevacizumab plus chemotherapy for the first-line treatment on patients with metastatic Colorectal Cancer（mCRC）.Methods Previously untreated 30 pa-tients with mCRC received treatment of L-OHP based on chemotherapy （FOLFOX or CapeOx）（n =18）or CPT-11 based on chemotherapy （FOLFIRI）（n =12）plus Bevacizumab.Bevacizumab was given with 5mg /kg every 2 weeks,or 7.5 mg/kg every 3 weeks.Response of treatment was evaluated during the treatment,and tox-icity was recorded at the same time.The survival time of these patients was also observed.The data were retro-spectively analyzed.Results 15 of 30 patients had partial responses and 10 patients got stable status and 5 pa-tients got progressive disease.The response rate was 50% and control rate of the disease was 83.3%.The me-dian progression free survival（PFS）was 10.809 months（95%CI：4.079 -15.921）.The adverse events related to Bevacizumab were hypertension on 3 patients,epistaxis on 1 patient,proteinuria on 1 patient.2 patients suf-fered from myelosuppression,and 4 patients suffered tardive diarrhea.Conclusion Bevacizumab combined with chemotherapy treatment is effective and the adverse effect is well to tolerated,which could be used as the first-line treatment for patients with mCRC.