| Ben Zhao,Lu Wang,Qianqian Yu,Guangyuan Hu,Hong Qiu,Mingsheng Zhang,Li Sun,Ping Peng,Xianglin Yuan. Outcomes of palliative local treatment in metastatic colorectal cancer patients receiving chemotherapy plus bevacizumab. Oncol Transl Med, 2018, 4: 93-100. |
| 姑息性局部治疗联合化疗及贝伐珠单抗治疗提高转移性结直肠癌患者总生存 |
| Outcomes of palliative local treatment in metastatic colorectal cancer patients receiving chemotherapy plus bevacizumab |
| Received:April 19, 2018 Revised:June 26, 2018 |
| DOI：10.1007/s10330-018-0273-3 |
| 中文关键词: 转移性结直肠癌，姑息性局部治疗，贝伐珠单抗，化疗，总生存期 |
| 英文关键词: metastatic colorectal cancer; palliative local treatment; bevacizumab; chemotherapy; overall survival |
| 基金项目: |
| Author Name | Affiliation | E-mail | | Ben Zhao | Department of Oncology,Tongji Hospital,Huazhong University of Science and Technology | zhaoben0609@163.com | | Lu Wang | Department of Oncology,Tongji Hospital,Huazhong University of Science and Technology | | | Qianqian Yu | Department of Oncology,Tongji Hospital,Huazhong University of Science and Technology | | | Guangyuan Hu | Department of Oncology,Tongji Hospital,Huazhong University of Science and Technology | | | Hong Qiu | Department of Oncology,Tongji Hospital,Huazhong University of Science and Technology | | | Mingsheng Zhang | Department of Oncology,Tongji Hospital,Huazhong University of Science and Technology | | | Li Sun | Department of Oncology,Tongji Hospital,Huazhong University of Science and Technology | | | Ping Peng | Department of Oncology,Tongji Hospital,Huazhong University of Science and Technology | | | Xianglin Yuan* | Department of Oncology,Tongji Hospital,Huazhong University of Science and Technology | xlyuan1020@163.com |
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| 中文摘要: |
| 目的：本研究旨在探讨在化疗联合靶向药物治疗的基础上联合使用姑息性局部治疗是否能进一步提高晚期不可治愈转移病灶的结直肠癌（mCRC）患者的总体生存。
方法：选取2011.1.1至2017.1.31期间在华中科技大学同济医学院附属同济医院肿瘤中心住院接受贝伐珠单抗治疗的mCRC患者105例。16（15%）例患者因贝伐珠单抗治疗不足4周期排除出组，最终89例符合入组标准的患者被纳入研究。89例入组患者根据是否接受过姑息性局部治疗分为两组：联合姑息性局部治疗组（33例）及未联合姑息性局部治疗组（56例）。主要研究终点为OS，采用Kaplan-Meier方法绘制生存曲线，采用Cox比例风险回归模型对所有可能影响生存的因素进行单因素及多因素分析。毒副反应事件根据不良反应常见术语标准（CTCAE V4.0）进行评估分级。利用Fisher精确检验及卡方检验分析比较两组患者1-2级，3-4级毒副反应事件差异。
结果：患者的中位随访时间为20.4月，随访时间范围1~60月，随访截止日期为2017年1月31日。至随访截止日期，姑息性局部治疗组的中位OS为36.3月（95%CI 33.4-39.2），未联合姑息性局部治疗组的中位OS为20.5月（95%CI 17.6-23.4）。单因素（HR=0.13，95%CI 0.05-0.30，P＜0.001）及多因素（HR=0.16，95%CI 0.07-0.39，P＜0.001）分析比较两组生存的差异具有统计学意义。两组患者一般化疗毒副反应事件及贝伐珠单抗特别相关毒副反应事件发生率没有统计学差异。
结论：在化疗联合贝伐珠单抗治疗的基础上，联合使用姑息性局部治疗是一种安全有效的治疗策略，能进一步改善mCRC患者的总生存期。 |
| 英文摘要: |
| Objective The aim of this study was to assess the value of palliative local treatment of incurable
metastatic lesions in colorectal cancer (CRC) patients receiving chemotherapy plus bevacizumab.
Methods Data of 105 patients with histologically confirmed synchronous or metachronous metastatic
CRC who received bevacizumab treatment from January 1, 2011 to January 31, 2017 were retrospectively
reviewed. Sixteen (15%) patients who were treated with bevacizumab for less than 4 cycles were excluded,
and finally, 89 (85%) patients were enrolled. Among them, 33 (37%) patients who received palliative local
treatment were categorized into the palliative local treatment group, and the remaining 56 (63%) patients
were categorized into the chemotherapy plus bevacizumab group. The primary endpoint was overall survival
(OS), which was calculated using Kaplan-Meier survival analyses. Factors possibly influencing survival
were evaluated by univariate and multivariate analyses. Adverse events (AEs) were graded according to
Common Terminology Criteria for Adverse Events, version 4.0. Grades 1–2 and 3–4 AEs of the two groups
were compared and analyzed using the Fisher’s exact test and χ2 analysis.
Results The median follow-up period was 20.4 months, ranging from 1 to 60 months. The median OS
in the palliative local treatment group was 36.3 months (95% CI, 33.5–39.2), and that in the chemotherapy
plus bevacizumab group was 20.5 months (95% CI, 17.6–23.4). Both the univariate (HR 0.13, 95% CI,
0.05–0.30, P < 0.001) and multivariate (HR 0.16, 95% CI, 0.07–0.39, P < 0.001) analyses showed that the
addition of palliative local treatment could prolong survival compared with chemotherapy plus bevacizumab
alone. There were no significant differences in the rates of common chemotherapy- or bevacizumab-related
AEs between the two groups.
Conclusion These findings suggest palliative local treatment is an effective and safe method for treating
patients with incurable metastatic CRC receiving chemotherapy plus bevacizumab. |
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