Cvetanovic A, Vrbic S, Filipovic S, Pejcic I, Milenkovic D, Milenkovic N, Zivkovic N
Clinical Centre Nis, Clinic of Oncology, Nis, Serbia.
J BUON. 2013 Jul-Sep;18(3):641-6.
To evaluate the safety and efficacy of the addition of bevacizumab to oxaliplatin-based preoperative chemotherapy in metastatic colorectal cancer (mCRC) patients.
Between August 2008 and December 2011, 51 patients with histologically documented CRC and liver metastases were treated with first-line oxaliplatin-based therapy plus bevacizumab: FOLFOX 4 (oxaliplatin, folinic acid and 5-FU) plus bevacizumab or OXFL mod.Mayo (folinic acid, oxaliplatin and 5-FU) plus bevacizumab.
The mean patient age was 59.69+ 9.38 years (range 38-78) and 34 (66.67%) were male. Complete response (CR) was achieved in 7 (13.73%) patients, partial response (PR) in 29 (56. 86%) and stable disease (SD) in 6 (11.76%); progressive disease (PD) was registered in 9 (17.65%) patients. Disease control rate was 82.36% (42 patients). Liver resections were performed in 37 (72.55%) patients vs those without resection (p<0.01). The same regimen without bevacizumab was administered postoperatively to 18 (42. 86%) patients. The mean progression free survival (PFS) was 9.90±7.07 months (range 3-26) and was significantly longer in patients with postoperative therapy (p<0.001). Treatment-related toxicity appeared in 28 (54. 90%) patients vs those who did not (p<0.001) Independent of grade, nausea (19.61%), leucopenia (17.65%) and peripheral neuropathy (17.65%) were the most frequent toxicities. Chemotherapy was postponed in 9 (17.65%) patients due to grade 3-4 toxicities. The most frequent grade 3 or 4 toxicities were leucopenia (5.88%) and hypertension (3.92%).
Bevacizumab plus oxaliplatin-based treatment is safe and efficient as preoperative treatment of mCRC with primarily unresectable liver metastases. Liver resection could offer a possibility for long-term survival in these patients.
评估在转移性结直肠癌（mCRC）患者中，将贝伐单抗添加到以奥沙利铂为基础的术前化疗中的安全性和疗效。
2008年8月至2011年12月期间，51例经组织学证实患有结直肠癌和肝转移的患者接受了一线以奥沙利铂为基础的治疗加贝伐单抗：FOLFOX 4（奥沙利铂、亚叶酸和5-氟尿嘧啶）加贝伐单抗或改良的OXFL Mayo方案（亚叶酸、奥沙利铂和5-氟尿嘧啶）加贝伐单抗。
患者平均年龄为59.69±9.38岁（范围38 - 78岁），男性34例（66.67%）。7例（13.73%）患者达到完全缓解（CR），29例（56.86%）患者部分缓解（PR），6例（11.76%）患者疾病稳定（SD）；9例（17.65%）患者疾病进展（PD）。疾病控制率为82.36%（42例患者）。37例（72.55%）患者接受了肝切除术，未接受切除术的患者为（p<0.01）。18例（42.86%）患者术后接受了不含贝伐单抗的相同方案治疗。平均无进展生存期（PFS）为9.90±7.07个月（范围3 - 26个月），术后接受治疗的患者PFS明显更长（p<0.001）。28例（54.90%）患者出现治疗相关毒性，未出现毒性的患者为（p<0.001）。无论级别如何，恶心（19.61%）、白细胞减少（17.65%）和周围神经病变（17.65%）是最常见的毒性反应。9例（17.65%）患者因3 - 4级毒性反应推迟化疗。最常见的3级或4级毒性反应是白细胞减少（5.88%）和高血压（3.92%）。
贝伐单抗加以奥沙利铂为基础的治疗作为主要不可切除肝转移的mCRC术前治疗是安全有效的。肝切除可为这些患者提供长期生存的可能性。
