Department of Gastroenterology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, China.
Department of Cardiothoracic Surgery, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China.
Medicine (Baltimore). 2021 Jul 30;100(30):e26714. doi: 10.1097/MD.0000000000026714.
It is necessary to systematically evaluate the clinical efficacy and safety of bevacizumab (BEV) combined with 5-fluorouracil + leucovorin + oxaliplatin (FOLFOX) regimen in the treatment of advanced colorectal cancer.
We searched the PubMed et al databases for randomized controlled trials (RCTs) on the BEV combined with the FOLFOX regimen in the treatment of advanced colorectal cancer up to January 20, 2021. The Cochrane Collaborations' risk of bias tool was used for the quality assessment of included RCTs. Revman5.3 software was used for meta-analysis.
Eleven RCTs with a total of 3178 patients with advanced colorectal cancer were included, meta-analysis results showed that the objective response rate (odds ratio [OR] = 3.15, 95% confidence intervals [CI]: 2.25-4.40, P < .001) and cancer control rate (OR = 2.73, 95% CI: 1.91-3.90, P < .001) of BEV + FOLFOX were higher than that of FOLFOX group. And the incidence of gastrointestinal adverse reactions (OR = 1.29, 95% CI: 1.07-1.55, P = .008) in the BEV + FOLFOX group was higher than that of the FOLFOX group, there were no significant differences in the incidence of leukopenia (OR = 1.04, 95% CI: 0.72-1.50, P = .83), hypertension (OR = 3.92, 95% CI: 0.81-18.88, P = .09) and neurotoxicity (OR = 1.00, 95% CI: 0.8-1.27, P = .98) between the 2 groups.
BEV combined with the FOLFOX regimen is more effective than the FOLFOX regimen alone in the treatment of advanced colorectal cancer, but it may also increase the risk of gastrointestinal adverse reactions.
有必要系统评估贝伐珠单抗（BEV）联合氟尿嘧啶+亚叶酸钙+奥沙利铂（FOLFOX）方案治疗晚期结直肠癌的临床疗效和安全性。
我们检索了截至 2021 年 1 月 20 日PubMed 等数据库中关于 BEV 联合 FOLFOX 方案治疗晚期结直肠癌的随机对照试验（RCT）。采用 Cochrane 协作偏倚风险工具对纳入的 RCT 进行质量评价。RevMan5.3 软件进行荟萃分析。
纳入 11 项 RCT，共 3178 例晚期结直肠癌患者，Meta 分析结果显示，BEV+FOLFOX 组客观缓解率（OR=3.15，95%CI：2.25-4.40，P<0.001）和癌症控制率（OR=2.73，95%CI：1.91-3.90，P<0.001）均高于 FOLFOX 组。BEV+FOLFOX 组胃肠道不良反应发生率（OR=1.29，95%CI：1.07-1.55，P=0.008）高于 FOLFOX 组，白细胞减少症发生率（OR=1.04，95%CI：0.72-1.50，P=0.83）、高血压发生率（OR=3.92，95%CI：0.81-18.88，P=0.09）和神经毒性发生率（OR=1.00，95%CI：0.8-1.27，P=0.98）在两组间无显著差异。
BEV 联合 FOLFOX 方案治疗晚期结直肠癌优于单独 FOLFOX 方案，但可能增加胃肠道不良反应风险。
