Long-term Follow-up Study Of The Efficacy And Safety Of Bevacizumab Combined With Chemotherapy In The Treatment Of Metastatic Colorectal Cancer

Objective: To observe the efficacy and safety of bevacizumab(Bev)combined with chemotherapy in the treatment of metastatic colorectal cancer for long-term follow-up,and to explore the responsiveness of different primary tumor sites to combined chemotherapy regiments,as well as the differences in the efficacy of different combined chemotherapy regiments.Method: A total of 95 patients with Metastatic colorectal cancer(mCRC)in our department from December 2012 to December 2016 were collected,including 65 patients who received Bev combined with chemotherapy.Among them,25 cases were combined with oxaliplatin(Capeox /mFOLFOX6/FOLFOX4+Bev),32 cases were combined with irinotecan(FOLFIRI+Bev),and 8 cases were combined with monotherapy(capecitabine/ratitrexed+Bev).Chemotherapy alone in 30 cases(FOLFIRI/CapeOX/ mFOLFOX6 /FOLFOX4 / capecitabine/ray for curved plug).In the 30 chemotherapy alone group,8cases received irinotecan based chemotherapy,12 cases received oxaliplatin based chemotherapy,and 10 cases received monotherapy.The end of follow-up was December2020.The effects of tumor site,number of treatment lines and combined chemotherapy regimen on the survival of mCRC were analyzed.Result: Patients receiving Bev,Total objective response rate(ORR)and disease control rate(DCR)were 16.92% and 69.23%.The overall median progression free survival(m PFS)and median Overall survival(m OS)were 9 months and 21 months.PFS of rectum was 3.37 months longer than that of left colon and 4.33 months longer than that of right colon,respectively,and the difference was significant(P<0.05).Compared with second-line and third-line patients,first-line treatment prolonged PFS by 8 and 10 months,and OS by 7and 10 months,respectively,with significant differences(P<0.05).Compared with oxaliplatin,monotherapy and chemotherapy alone,irinotecan group had a longer OS of 10 months,16 months and 14 months,respectively.There were adverser events like hypertension(6 cases 9.23%),proteinuria(1cases 1.54%),rashes(1cases 1.54%).The symptoms improved after observation and oral medication.Conclusion: The long-term follow-up results showed that :1.Bev combined with chemotherapy has a definite effect on metastatic colorectal cancer.2.Early application of Bev can increase patients’ m PFS;3.The m PFS of the rectum is longer than that of the left and right colon;Compared with oxaliplatin and monotherapy,irinotecan showed a more significant advantage in patients with OS.4.Bev combined with chemotherapy in the treatment of metastatic colorectal cancer can be tolerated by adverse regimens.