應(yīng)佳可 楊翀 孔穎 蘇燕燕

[摘要] 目的 評(píng)價(jià)與分析貝伐珠單抗與化療聯(lián)合治療晚期結(jié)腸癌的效果及對(duì)不良反應(yīng)發(fā)生率的影響。 方法 以我院2017年1月～2019年12月期間接診的結(jié)腸癌患者為研究對(duì)象，從中篩選60例結(jié)腸癌晚期患者，根據(jù)治療方案的不同分為對(duì)照組（n=30）和觀察組（n=30），對(duì)照組實(shí)施對(duì)癥的化療措施，觀察組實(shí)施對(duì)癥化療+貝伐珠單抗聯(lián)合治療，比較兩組患者的治療效果、外周血循環(huán)腫瘤細(xì)胞（CTCs）陽性率和不良反應(yīng)情況。 結(jié)果 兩組患者的完全緩解例數(shù)和緩解率比較，差異均無統(tǒng)計(jì)學(xué)意義（P>0.05），觀察組部分緩解、病情穩(wěn)定和疾病控制率均高于對(duì)照組（P<0.05）;觀察組治療前后CTCs陽性率比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05），對(duì)照組治療前后比較，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且觀察組明顯低于對(duì)照組（P<0.05）;兩組患者的神經(jīng)毒性、肝功能損傷和Ⅰ～Ⅱ度骨髓抑制比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05），而觀察組的惡心、嘔吐情況和Ⅲ～Ⅳ度骨髓抑制情況均低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。 結(jié)論 貝伐珠單抗與化療聯(lián)合治療晚期結(jié)腸癌，可以減緩疾病的進(jìn)展，降低CTCs陽性率，并可減少惡心、嘔吐的發(fā)生率，減弱骨髓抑制的程度，值得臨床推廣。

[關(guān)鍵詞] 貝伐珠單抗;化療;結(jié)腸癌;循環(huán)腫瘤細(xì)胞;不良反應(yīng)

[中圖分類號(hào)] R735.34? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] B? ? ? ? ? [文章編號(hào)] 1673-9701（2020）28-0070-04

Observation of the efficacy of bevacizumab combined with chemotherapy in the treatment of advanced colon cancer and its impact on adverse reactions

YING Jiake? ?YANG Chong? ?KONG Ying? ?SU Yanyan

Department of General Surgery，Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine，Hangzhou 310003，China

[Abstract] Objective To evaluate and analyze the effect of bevacizumab combined with chemotherapy in the treatment of advanced colon cancer and its impact on the incidence of adverse reactions. Methods A total of 60 patients with advanced colon cancer were screened from colon cancer patients in our hospital from January 2017 to December 2019 and were divided into a control group（n=30） and an observation group（n=30） according to different treatment schemes. The former group implemented symptomatic chemotherapy， and the latter group implemented symptomatic chemotherapy+bevacizumab combination therapy. The treatment effect， the positive rate of CTCs and adverse reactions between the two groups were compared. Results There were no significant differences in the number of complete remission cases and remission rate between the two groups（P>0.05）. The partial remission， stable condition and disease control rate of the observation group were higher than those of the control group（P<0.05）. After treatment， the positive rate of CTCs of the observation group was not significantly different from that before treatment（P>0.05）. There was significant difference in the positive rate of CTCs in the control group before and after treatment（P<0.05）. The positive rate of CTCs in the observation group was significantly lower than that in the control group（P<0.05）. There were no significant differences in neurotoxicity，liver function damage and Ⅰ-Ⅱdegree bone marrow suppression between two groups（P>0.05）， while the nausea， vomiting and Ⅲ-Ⅳ degree bone marrow suppression in the observation group were lower than those in the control group（P<0.05）. Conclusion The combination of bevacizumab and chemotherapy in the treatment of advanced colon cancer can slow the disease progression，reduce the positive rate of CTCs， and can reduce the incidence of nausea and vomiting， and reduce the degree of bone marrow suppression. It is worthy of clinical promotion.