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贝伐珠单抗联合FOLFIRI方案治疗晚期结肠癌的临床观察
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| 篇名： | 贝伐珠单抗联合FOLFIRI方案治疗晚期结肠癌的临床观察 |
| TITLE： | |
| 摘要： | 目的： 观察贝伐珠单抗联合伊立替康+亚叶酸钙+氟尿嘧啶（FOLFIRI）方案治疗晚期结肠癌的疗效、毒副反应及患者生存率。方法：选择我院肿瘤科2010年1月－2014年8月收治的113例晚期结肠癌患者作为研究对象，按照随机数字表法分为观察1组（40例）、观察2组（39例）和对照组（34例）。3组化疗方案均为FOLFIRI方案，观察1组、2组在此基础上分别联用贝伐珠单抗注射液5、7.5 mg/kg，14 d为1个周期，均治疗8个周期。比较3组患者的临床疗效，治疗前后血管内皮生长因子A（VEGF-A）阳性率、免疫指标（T细胞亚群中CD3+、CD3+CD4+、CD3+CD8+细胞所占比例）、毒副反应发生率及1年/2年生存率。结果：观察1组、2组患者的临床总有效率均显著高于对照组，VEGF-A阳性率均显著低于对照组，差异均有统计学意义（P＜0.05）。3组患者CD3+、CD3+CD4+、CD3+CD8+所占比例均较治疗前显著降低，但观察1组、2组患者的显著高于对照组，差异均有统计学意义（P＜0.05）。观察1组及对照组患者的高血压（3～4级）发生率均显著低于观察2组，观察1组和观察2组患者的白细胞减少（3～4级）发生率均显著低于对照组，差异均有统计学意义（P＜0.05）。3组患者1年生存率比较，差异无统计学意义（P＞0.05）；观察1组、2组患者的2年生存率均显著高于对照组，差异有统计学意义（P＜0.05）。结论：不同剂量贝伐珠单抗联合FOLFIRI方案治疗晚期结肠癌均有明显增效作用，可有效抑制VEGF-A，并发挥免疫保护和抗毒副作用，延长患者生存期；低剂量贝伐珠单抗的高血压发生率更低，安全性更高。 |
| ABSTRACT： | OBJECTIVE： To observe therapentic efficacy of bevacizumab combined with irinotecan+leucovorin+fluorouracil （FOLFIRI） plan in the treatment of advanced colon cancer， toxic reaction and patients’survival rate. METHODS： A total of 113 patients with advanced colon cancer admitted to the oncology department in our hospital from Jan. 2010 to Aug. 2014 were randomized into observation group 1 （40 cases）， observation group 2 （39 cases） and control group （34 cases）. Three groups received FOLFIRI； observation group 1 and 2 were additionally given Bevacizumab injection 5 and 7.5 mg/kg 14 d as a treatment course， for 8 cycles. Clinical efficaices as well as the positive rate of VEGF-A， immune indexes （the proportion of CD3+， CD3+CD4+， CD3+CD8+ in T cell subset） before and after treatment， the incidence of toxic reaction， 1-year and 2-year survival rates were compared among 3 groups. RESULTS： The total response rate of observation group 1 and 2 were significantly higher than control group， and the positive rate of VEGF-A in observation group 1 and 2 were significantly lower than control group， with statistical significance （P＜0.05）. The proportion of CD3+， CD3+CD4+ and CD3+CD8+ in 3 groups were significantly lower than before treatment， but observation group 1 and 2 were significantly higher than control group， with statistical significance （P＜0.05）. The incidence of grade hypertension （grade 3-4） in observation group 1 and control group were lower than observation group 2； the incidence of leucopenia （grade 3-4） in observation group 1 and 2 were significantly lower than control group， with statistical significance （P＜0.05）. There was no statistical significance in 1-year survival rate among 3 groups （P＞0.05）. 2-year survival rate of observation group 1 and 2 were significantly higher than control group， with statistical significance （P＜0.05）. CONCLUSIONS： For advanced colon cancer， different doses of bevacizumab combined with FOLFIRI have significant synergistic effect， can effectively inhibit VEFG-A， play a role of immune protection and anti-toxic side effects， and prolong the survival time. The incidence of hypertension in patients treated with low-dose bevacizumab is relatively lower and the safety is better. |
| 期刊： | 2017年第28卷第23期 |
| 作者： | 周芳，王建军，程传耀，卢红 |
| AUTHORS： | ZHOU Fang，WANG Jianjun，CHENG Chuanyao，LU Hong |
| 关键字： | 晚期结肠癌；贝伐珠单抗；化疗；毒副反应；免疫保护 |
| KEYWORDS： | Advanced colon cancer； Bevacizumab； Chemotherapy； ADR； Immune protection |
| 阅读数： | 4633 次 |
| 本月下载数： | 16 次 |
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