贝伐单抗治疗K-ras突变型的转移性结直肠癌的临床观察

摘要

目的观察贝伐单抗联合化疗治疗 K-ras 突变型的转移性结直肠癌的近期疗效及安全性.方法回顾性分析我院23例 K-ras 突变型的转移性结直肠癌,均接受化疗联合贝伐单抗(5mg/kg,qw)治疗,4周为1个周期,两个周期后根据 RECIST 标准评价疗效,并观察PFS 及不良反应.结果所有患者中有21例进行疗效评价,其中 CR 0例,PR 5例,SD 9例,PD 7例.客观有效率为24%,疾病控制率为67%,中位疾病进展时间( mTTP)6.4个月.不良反应主要为骨髓抑制,肝功能异常,腹泻,其次为高血压1例,鼻出血1例,对症治疗后均缓解,无胃肠道穿孔病例.结论贝伐单抗联合化疗可提高 K-ras 突变型的晚期结直肠癌的的疾病控制率,且不良反应轻,患者耐受性较好.%　　Objective To investigate the efficacy and safety of Bevacizumab in advanced colorectal cancer patients with K-ras mutation. Methods Twenty three patients with advanced colorectal cancer with K-ras mutation were analyzed retrospectively. The patients were received the treatment with bevacizumab combined with different chemotherapy, 28 day course.The efficacy and toxicity were evaluated at the end of two cycles. Results According to Response Evaluation Criteria in Solid Tumours Criteria, Among the 21 assessable patients, none achieved complete response (CR), 5 patients partial response ( PR) , 9 patients stable disease ( SD) and 7 patients progressive disease ( PD). The median TTP (mTTP) was 6.4 months. The main side affects were bone marrow suppression,hepatic insufficiency and diarrhea. No gastrointestinal perforation was found. Conclusion Bevacizumab combined with chemotherapy can improve the recent biological response rate and delay TTP in advanced colorectal cancer patients with K-ras mutation with low incidence of side effects.