化疗联合贝伐珠单抗治疗结直肠癌肝转移的临床观察
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篇名: 化疗联合贝伐珠单抗治疗结直肠癌肝转移的临床观察
TITLE:
摘要:

目的:观察化疗联合贝伐珠单抗治疗结直肠癌肝转移(CLMs)的疗效及肝脏毒性反应。方法:126 例结直肠癌肝转移瘤

患者按随机数字表法分为化疗组(54 例)和联合组(72 例)。化疗组患者使用FOLFOXIRI化疗方案:伊立替康165 mg/m2+奥沙利

铂85 mg/m2+亚叶酸钙200 mg/m2+氟尿嘧啶2 g;联合组患者在FOLFOXIRI方案基础上于化疗前1 天加用5 mg/kg 贝伐珠单抗。2

周为1 个疗程,两组患者均治疗12 个疗程。比较两组患者的病理学应答、生存率及化疗引起的肝脏毒性反应。结果:联合组患者

病理学完全应答率、肿瘤消退等级(TRG)4~5、患者比例、肿瘤坏死率≥50%患者比例显著高于化疗组,差异均有统计学意义(P<

0.01);联合组患者TRG 4~5、TRG 1~3 生存率显著高于化疗组,差异有统计学意义(P<0.05);联合组患者肝脏实质坏死发生率

显著低于化疗组,差异有统计学意义(P<0.05)。结论:化疗联合贝伐珠单抗治疗能够改善患者病理学应答和CLMs的坏死程度,

且不会增加肝脏毒性反应。

ABSTRACT:

OBJECTIVE:To observe therapeutic efficacy and liver toxicity of chemotherapy combined with bevacizumab in the

treatment of colorectal cancer liver metastases(CLMs). METHODS:126 CLMs patients were selected and randomly divided into

chemotherapy group(54 cases)and combination group(72 cases). Chemotherapy group received FOLFOXIRI regimen:irinotecan

165 mg/m2+ oxaliplatin 85 mg/m2+ calcium folinate 200 mg/m2+ fluorouracil 2 g. Combination group was additionally given bevacizumab

5 mg/kg one day before chemotherapy on the basis of FOLFOXIRI regimen. A treatment course of 2 groups lasted for 2

weeks,and both received 12 courses of treatment. The pathological response,survival rate and toxic reactions caused by chemotherapy

were compared between 2 groups. RESULTS:Pathological complete response proportion,tumor remission rating(TRG),the

proportion of patients with tumor necrosis rate ≥50% in combination group were significantly higher than chemotherapy group,

with statistical significance(P<0.01). The proportion of TRG4-5,TRG 1-3 progression-free survival in combination group were

significantly higher than chemotherapy group,with statistical significance(P<0.05). The incidence of liver parenchymal necrosis

in combination group was significantlg higher than chemotherapy group,there was statistical significance(P>0.05). CONCLUSIONS:

Chemotherapy combined with bevacizumab can improve pathological response and the incidence of CLMs necrosis and

doesn’t increase liver toxicity.

期刊: 2015年第26卷第35期
作者: 马宁,王朝杰,周云
AUTHORS: MA Ning,WANG Chao-jie,ZHOU Yun
关键字: 贝伐珠单抗;结直肠癌;联合化疗;肝转移瘤
KEYWORDS: Bevacizumab;Colorectal cancer;Combined chemotherapy;Liver metastasis
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