Ozcelik M, Odabas H, Ercelep O, Yuksel S, Mert A G, Aydin D, Surmeli H, Isik D, Isik S, Oyman A, Oven Ustaalioglu B B, Aliustaoglu M, Gumus M
Department of Medical Oncology, Kartal Dr. Lutfi Kirdar Education and Research Hospital, 34865, Istanbul, Turkey.
Department of Medical Oncology, Haydarpasa Numune Education and Research Hospital, 34668, Istanbul, Turkey.
Clin Transl Oncol. 2016 Jun;18(6):617-24. doi: 10.1007/s12094-015-1408-6. Epub 2015 Oct 12.
The optimal treatment in older persons with metastatic colorectal cancer (mCRC) is complicated by a lack of general agreement. The aim of this study was to evaluate the activity of bevacizumab plus capecitabine combination in elderly mCRC patients who were not suitable for chemotherapy with irinotecan and oxaliplatin-containing regimens.
Seventy years and older patients with metastatic colorectal carcinoma were included in this retrospective study. Bevacizumab was administered at a dose of 7.5 mg/kg on day 1 as an intravenous (IV) infusion over 30-90 min every 21 days, and capecitabine was prescribed at 1000 mg/m(2) twice daily on days 1-14 of the same 21-day schedule.
Eighty-two consecutive patients (47 men, 35 women) were included in the study. The mean age was 75.5 (SD 3.9, range 70-87). Half of the patients were older than 75 years. There were 55 patients (67.1 %) with a good Eastern Cooperative Oncology Group (ECOG) performance status (PS: 0-1) and the remaining 27 patients (32.9 %) had a poor ECOG performance status (PS: 2). With a median follow-up period of 18.5 months, the median progression-free survival (PFS) was 10 months (95 % CI, 7.8-12.1) and the median OS was 25 months (95 % CI, 18.6-31.3). The main toxicities recorded were non-hematological. Thirty-one patients (37 %) experienced grade 3/4 adverse events, the most common being hand-foot syndrome (9.8 %). No fatal toxicity resulting from this regimen was recorded.
Considering the toxicity profile and survival outcomes, the combination regimen of capecitabine and bevacizumab is a potentially feasible treatment option in elderly mCRC patients.
转移性结直肠癌（mCRC）老年患者的最佳治疗方案尚无普遍共识，这使得治疗变得复杂。本研究的目的是评估贝伐单抗联合卡培他滨方案在不适合使用含伊立替康和奥沙利铂化疗方案的老年mCRC患者中的活性。
本回顾性研究纳入了70岁及以上的转移性结直肠癌患者。贝伐单抗剂量为7.5mg/kg，于第1天静脉输注30 - 90分钟，每21天一次；卡培他滨在相同的21天疗程的第1 - 14天，每日两次，每次1000mg/m²。
82例连续患者（47例男性，35例女性）纳入研究。平均年龄为75.5岁（标准差3.9，范围70 - 87岁）。一半患者年龄超过75岁。东部肿瘤协作组（ECOG）体能状态良好（PS：0 - 1）的患者有55例（67.1%），其余27例患者（32.9%）ECOG体能状态较差（PS：2）。中位随访期为18.5个月，中位无进展生存期（PFS）为10个月（95%CI，7.8 - 12.1），中位总生存期（OS）为25个月（95%CI，18.6 - 31.3）。记录的主要毒性为非血液学毒性。31例患者（37%）发生3/4级不良事件，最常见的是手足综合征（9.8%）。未记录到该方案导致的致命毒性。
考虑到毒性特征和生存结果，卡培他滨和贝伐单抗联合方案是老年mCRC患者潜在可行的治疗选择。
