Division of Surgical Oncology, Erasmus University MC, Daniel den Hoed Cancer Centre, Rotterdam, The Netherlands.
J Surg Oncol. 2012 Dec;106(7):892-7. doi: 10.1002/jso.23142. Epub 2012 May 2.
Chemotherapy (CTx) before resection of colorectal liver metastases (CRLM) may cause hepatic injury and postoperative complications. To ascertain whether adding bevacizumab, a monoclonal antibody against VEGF, to oxaliplatin-based CTx has an influence on liver injury and postoperative complications.
Patients with CRLM who received neoadjuvant CTx and underwent resection between 2003 and 2008 were analyzed whether or not they received bevacizumab added to oxaliplatin-based CTx.
The total study group existed of 104 patients: 53 patients received oxaliplatin-based CTx and 51 patients received oxaliplatin-based CTx and bevacizumab. The overall complication rate (29%) was not significantly different between the two groups. The bevacizumab group exhibited less moderate sinusoidal dilatation (8% vs. 28%, P = 0.01). No difference in complication rate was found between patients given fewer than six cycles of oxaliplatin-based CTx and those given six or more cycles, or between patients with a short (<5 weeks) interval between the last dose of oxaliplatin and resection and those in which the interval was longer.
Bevacizumab added to oxaliplatin-based CTx may protect against moderate sinusoidal dilatation without significantly influencing morbidity. Neither duration of oxaliplatin-based CTx nor the time interval between cessation of oxaliplatin-based CTx and surgery were associated with postoperative complications.
结直肠癌肝转移(CRLM)切除术前行化疗(CTx)可能导致肝损伤和术后并发症。为了确定在奥沙利铂为基础的 CTx 中加入抗血管内皮生长因子(VEGF)的单克隆抗体贝伐珠单抗是否会对肝损伤和术后并发症产生影响。
分析了 2003 年至 2008 年间接受新辅助 CTx 并接受切除术的 CRLM 患者是否接受了奥沙利铂为基础的 CTx 加贝伐珠单抗治疗。
总研究组共 104 例患者:53 例患者接受奥沙利铂为基础的 CTx,51 例患者接受奥沙利铂为基础的 CTx 和贝伐珠单抗。两组的总体并发症发生率(29%)无显著差异。贝伐珠单抗组中度窦状扩张的发生率较低(8% vs. 28%,P=0.01)。接受少于 6 个周期奥沙利铂为基础的 CTx 的患者与接受 6 个或更多周期的患者之间,或末次奥沙利铂剂量与手术之间间隔较短(<5 周)的患者与间隔较长的患者之间,并发症发生率无差异。
奥沙利铂为基础的 CTx 中加入贝伐珠单抗可能会预防中度窦状扩张,而不会显著影响发病率。奥沙利铂为基础的 CTx 的持续时间以及奥沙利铂为基础的 CTx 停止与手术之间的时间间隔与术后并发症无关。