贝伐珠单抗联合化疗在左右半结肠癌中疗效对比及安全性分析

Efficacy Comparison and Safety Analysis of Bevacizumab Combined with Chemotherapy in Left and Right Colon Cancer

摘要: 目的：对比左右半结肠癌中，贝伐珠单抗联合化疗的疗效及安全性的差异。方法：收集2018年1月至2022年12月新疆医科大学附属肿瘤医院消化内科139例接受贝伐珠单抗联合化疗治疗的晚期结肠癌患者临床资料，根据原发肿瘤部位不同分为左半结肠癌组(LSCC，n = 62例)与右半结肠癌组(RSCC，n = 77例)，对比两组患者的临床基线资料、客观缓解率(ORR)、疾病控制率(DCR)、不良反应率、无进展生存期(PFS)及总生存期(OS)。结果：LSCC组达到PR患者21例，SD 32例，PD 9例，RSCC组达到PR患者19例，SD 49例，PD 9例，两组患者均无达到CR病例。LSCC组及RSCC组患者ORR分别为33.9%%和24.7% (P > 0.05)，DCR分别85.5%和88.3% (P > 0.05)。在不良反应方面，两组患者治疗过程中的主要不良反应包括骨髓抑制、肝肾功能损害、蛋白尿、手足综合征、高血压、胃肠道反应，LSCC组与RSCC组不良反应总发生率比较，差异无统计学意义(32.2% vs 48.1%, χ² = 5.290, P = 0.525)。LSCC组中位PFS优于RSCC组患者(10.8个月vs 8.6个月，P = 0.041)，LSCC组中位OS优于RSCC组患者(21.5个月vs 19.7个月，P = 0.038)。结论：左、右半结肠癌患者接受贝伐珠单抗联合化疗治疗的远期疗效存在差异，两组安全性相当。

Abstract: Objective: To compare the efficacy and safety of bevacizumab combined with chemotherapy in left and right colon cancer. Method: Clinical data of 139 patients with advanced colon cancer who received bevacizumab combined with chemotherapy in the Department of Gastroenterology, Xinjiang Medical University Affiliated Cancer Hospital from January 2018 to December 2022 were collected, divided into left colon cancer group (LSCC, n = 62 cases) and right colon cancer group (RSCC, n = 77 cases) based on different locations of the primary tumor, compare the clinical baseline data, objective response rate (ORR), disease control rate (DCR), adverse reaction rate, progression free survival (PFS), and overall survival (OS) between two groups of patients. Result: There were 21 PR patients, 32 SD patients, and 9 PD patients in the LSCC group, and 19 PR patients, 49 SD patients, and 9 PD patients in the RSCC group. There were no cases of CR patients in either group. The ORR of patients in the LSCC group and RSCC group were 33.9% and 24.7%, respectively (P > 0.05), while the DCR was 85.5% and 88.3%, respectively (P > 0.05). In terms of adverse reactions, the main adverse reactions during the treatment of the two groups of patients included bone marrow suppression, liver and kidney dysfunction, proteinuria, hand foot syndrome, hypertension, and gastrointestinal reactions. The total incidence of adverse reactions in the LSCC group and RSCC group was not statistically significant (32.2% vs 48.1%, χ² = 5.290, P = 0.525). The median PFS in the LSCC group was better than that in the RSCC group (10.8 months vs 8.6 months, P = 0.041), and the median OS in the LSCC group was better than that in the RSCC group (21.5 months vs 19.7 months, P = 0.038). Conclusion: There is a difference in the long-term efficacy of bevacizumab combined with chemotherapy in left and right colon cancer patients, and the safety of the two groups is equivalent.