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中华普通外科学文献(电子版)

中华普通外科学文献(电子版) ›› 2015, Vol. 09 ›› Issue (03) : 206 -210. doi: 10.3877/cma.j.issn.1674-0793.2015.03.007

所属专题： 文献；

论著

贝伐单抗联合FOLFOX4方案治疗晚期结直肠癌的临床疗效观察
韩志军1,†()   
  1. 1. 064000　唐山，唐山市丰润区人民医院
  • 收稿日期:2014-11-11 出版日期:2015-06-01
  • 通信作者: 韩志军

Clinical efficacy of bevacizumab in combination with FOLFOX4 regimen in the treatment of advanced colorectal cancer

Zhijun Han1,†()   

  1. 1. Fengrun District People’s Hospital of Tangshan City, Tangshan 064000, China
  • Received:2014-11-11 Published:2015-06-01
  • Corresponding author: Zhijun Han
  • About author:
    Corresponding author: Han Zhijun, Email:
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引用本文：

韩志军. 贝伐单抗联合FOLFOX4方案治疗晚期结直肠癌的临床疗效观察[J]. 中华普通外科学文献(电子版), 2015, 09(03): 206-210.

Zhijun Han. Clinical efficacy of bevacizumab in combination with FOLFOX4 regimen in the treatment of advanced colorectal cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2015, 09(03): 206-210.

目的

观察在直肠癌治疗中联合贝伐单抗及FOLFOX4治疗方案的应用价值。

方法

回顾性总结2007年7月至2011年7月期间本院收治的晚期结直肠癌患者87例,按照治疗方案分为试验组(42例)和对照组(45例)。试验组接受贝伐单抗+FOLFOX4方案治疗,对照组只接受FOLFOX4方案治疗,比较两组患者的近期疗效、远期疗效及不良反应。

结果

试验组和对照组有效率分别为40.5%和17.8%(χ2=5.466,P<0.05),差异有统计学意义;疾病控制率分别为71.4%和44.4%(χ2=6.472,P<0.05),差异有统计学意义。两组远期疗效比较,试验组2年生存率为85.71%,对照组为66.67%,试验组明显高于对照组(P<0.05)。试验组的中位总生存期和中位无进展生存期分别为15.6和8.9个月,明显优于对照组的10.6和5.8个月,差异均有统计学意义(P<0.05)。两组患者不良反应多为Ⅰ-Ⅱ级,差异无统计学意义。

结论

贝伐单抗联合FOLFOX4方案治疗晚期结直肠癌患者效果优于单用FOLFOX4方案治疗,且患者不良反应无明显增加。

关键词: 贝伐单抗, FOLFOX4方案, 晚期结直肠癌
Objective

To explore the efficacy and safety of advanced colorectal cancer patients treated by bevacizumab in combination with FOLFOX4 regimen.

Methods

Eighty-seven patients with advanced colorectal cancer were divided into bevacizumab combined with FOLFOX4 regimen group (the study group, 42 cases) and FOLFOX4 regimen only group (the control group, 45 cases) according to the treatment program. The efficacy, side effects and survival time in two groups were observed and compared.

Results

The response rate (RR) of the study and control group was 40.5% and 17.8%, respectively, and the disease control rate (DCR) of the two groups was 71.4% and 44.4%, respectively; both differences were statistically significant (P<0.05). The median disease free survival (DFS) of study group and control group was 8.9 and 5.8 months, respectively; the median overall survival (OS) of the two groups was 15.6 and 10.6 months, respectively; the differences were statistically significant (P<0.05). The side effects in two groups included diarrhea and gastrointestinal reactions, but all were grade Ⅰ-Ⅱ.

Conclusion

The efficacy of bevacizumab combined with FOLFOX4 regimen is reliable in treating patients with advanced colorectal cancer. It can increase the response rate and prolong median overall survival with low side effects.

Key words: Bevacizumab, FOLFOX4, Advanced colorectal cancer
表1 研究对象一般资料比较
特征 试验组(42例) 对照组(45例) t/χ2值 P值
年龄(岁) 53.23±10.21 55.68±12.87 0.97 0.33
患病时间(年) 0.65±0.07 0.63±0.06 1.43 0.15
分化程度(例) ? ? -1.73 0.08
? 高 10 9 ? ?
? 中 17 21 ? ?
? 低 15 15 ? ?
性别(例) ? ? 0.07 0.78
? 男 20 26 ? ?
? 女 22 19 ? ?
表2 试验组与对照组近期疗效比较
近期疗效 试验组(42例) 对照组(45例) χ2/z值 P值
例数 % 例数 %
CR 2 4.76 0 0.00 ? ?
PR 15 35.71 8 17.78 ? ?
SD 13 30.95 12 26.67 ? ?
PD 12 28.57 25 55.56 5.47 0.02
RR 17 40.48 8 17.78 6.47 0.01
DCR 30 71.43 20 44.44 ? ?
图1 试验组与对照组OS比较
图2 试验组与对照组PFS比较
表3 试验组与对照组不良反应比较[例(%)]
项目 Ⅰ级 Ⅱ级
试验组(42例) 对照组(45例) 试验组(42例) 对照组(45例)
腹泻 3(7.14) 1(2.22) 2(4.76) 0(0)
恶心呕吐 2(4.76) 0(0) 1(2.38) 1(2.22)
出血 1(2.38) 2(4.44) 0(0) 0(0)
高血压 0(0) 1(2.22) 1(2.38) 3(6.67)
蛋白尿 0(0) 2(4.44) 0(0) 1(2.22)
心脏毒性 1(2.38) 1(2.22) 0(0) 1(2.22)
总发生率 7(16.67) 7(15.56) 4(9.52) 6(13.33)
χ2值 0.028 0.309
P值 0.868 0.577
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