文章摘要

贝伐珠单抗腹腔灌注治疗在消化道肿瘤中的应用价值

作者: 1吴芳芳, 1孙兆楼, 1马善义, 1杨帆
1 宣城市中心医院肿瘤内科,安徽 宣城 242000
通讯: 杨帆 Email: 3467213006@qq.com
DOI: 10.3978/j.issn.2095-6959.2020.12.019

摘要

目的:探究腹腔内贝伐珠单抗灌注治疗消化道肿瘤的临床疗效和安全性。 方法:选取2013年1月至2016年10月于宣城市中心医院就诊的消化道肿瘤伴恶性腹腔积液患者50例为研究对象,随机数字表法分为单纯化疗组(对照组,n=25)与贝伐珠单抗腹腔灌注联合化疗组(实验组,n=25)。50例患者均行基础全身静脉化疗并于治疗前排空腹水,实验组在对照组基础上加用贝伐珠单抗腹腔灌注治疗,记录两组患者近期临床疗效、治疗前后腹水血管内皮生长因子(vascular endothelial growth factor,VEGF)水平变化、血清肿瘤标志物水平、不良反应发生情况、卡氏(Karnofsky,KPS)评分变化,并随访记录3年生存率与肿瘤复发情况等指标。结果:治疗后实验组近期临床总有效率显著高于对照组(80.00% vs 44.00%,P=0.002);治疗后两组患者腹水VEGF水平及血清甲胎蛋白(alpha fetoprotein,AFP)、癌胚抗原(carcino-embryonic antigen,CEA)、CA199等肿瘤标志物水平较治疗前均显著降低,且实验组水平较对照组更低(P<0.05);治疗后两组患者不良反应发生率相比,差异无统计学意义(P>0.05);治疗后两组患者生存质量(quality of life,QOL)比较,实验组QOL改善例数显著多于对照组(P<0.05);随访3年,实验组第1,2,3年生存率均显著高于对照组(P<0.05),3年内肿瘤复发率显著低于对照组(P<0.05)。结论:应用贝伐珠单抗腹腔灌注治疗消化道肿瘤临床疗效好,可提高患者生存质量和3年生存率,降低肿瘤复发率,且不增加不良反应发生,值得进一步推广应用。
关键词: 消化道肿瘤;贝伐珠单抗;腹腔灌注化疗;疗效

Value of intraperitoneal infusion of bevacizumab in the treatment of digestive tract tumors

Authors: 1WU Fangfang, 1SUN Zhaolou, 1MA Shanyi, 1YANG Fan
1 Department of Medical Oncology, Xuancheng Central Hospital, Xuancheng Anhui 242000, China

CorrespondingAuthor: YANG Fan Email: 3467213006@qq.com

Abstract

Objective: To explore the clinical efficacy and safety of intraperitoneal bevacizumab infusion in the treatment of digestive tract tumors. Methods: Fifty patients with digestive tract tumors with malignant ascites treated in our hospital from January 2013 to October 2016 were randomly divided into two groups: simple chemotherapy group (the control group, n=25) and bevacizumab intraperitoneal perfusion combined chemotherapy group (the experimental group, n=25). All patients received basic systemic intravenous chemotherapy and emptied ascites before treatment. the experimental group was treated with bevacizumab intraperitoneal perfusion in addition to the control group. The short-term clinical efficacy, the changes of vascular endothelial growth factor (VEGF) level in ascites, serum tumor markers, toxicity, and side effects, Karnofsky (KPS) score, 3-year survival rate and tumor recurrence were recorded. Results: After treatment, the short-term clinical total effective rate of the experimental group was significantly higher than that of the control group (80.00% vs 44.00%, P=0.002). After treatment, the levels of ascites VEGF and serum tumor markers such as alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA) and CA199 in the two groups were significantly lower than those before treatment, and the level of the experimental group was lower than that of the control group (P<0.05). There was no significant difference in the incidence of toxicity and side effects between the two groups after treatment (P>0.05), but the QOL of quality of life in the experimental group was significantly higher than that in the control group (P<0.05), and the 1, 2 and 3-year survival rates in the experimental group were significantly higher than those in the control group (P>0.05), and the tumor recurrence rate within 3 years was significantly lower than that in the control group (P>0.05). Conclusion: The short-term clinical effect of intraperitoneal infusion of bevacizumab in digestive tract tumors is good, which can significantly improve the quality of life and 3-year survival rate, reduce the tumor recurrence rate, and do not increase the incidence of adverse reactions, so it is worth further popularizing and applying.
Keywords: digestive tract neoplasms; bevacizumab; intraperitoneal infusion chemotherapy; therapeutic effect