Study Of Neoadjuvant Therapy Combination With Bevacizumab In The Middleand Low Rectalcancer

Objective: To explore the efficacy and safety of bevacizumabcombination in neoadjuvant therapy in the middle and low locallyadvanced rectal cancer.Methods: Middle and low locally advanced rectal cancer patientswho treated by bevacizumab combination with neoadjuvant therapy werethe observation group during November2010to Octorber2013, and thepatients treated by FOLFOX were the control group. The pathologicalcomplete response rates (pCR), tumor downstaging rate, anal sphincterpreservation rate, the incidence of adverse events and perioperationcomplications were compared between the two groups. The SPSS17.0software was used to data analysis and P <0.05was thought to be statisticalsignificance.Results:Total of17subjects were comprised in the observation groupwith11males and6females, and total of23subjects were collected in the control group with14males and9females. There was no statisticalsignificance of age, sex, the distance of tumor to anal margin and tumorstage before operation between the two groups (p>0.05). Observationgroup/control group: pCR rate17.6%/13.0%(P=0.69); tumor downstagingrate76.5%/73.9%(P=0.87); anal sphincter preservation rate76.9%/76.5%(P=0.85); the incidence of adverse events70.5%/65.2%(P=0.67); surgicaltime202.94±24.63min/203.91±28.52min(p=0.91); amount of bleedingduring surgery207.35±27.75ml/204.87±21.47ml(p=0.75); anastomoticfistula rate7.1%/5.2%(P=0.84); the amount of anterior sacral drainage213.24±33.54ml/211.74±31.82ml(p=0.89); wound healing time11.2±2.43d/10.91±3.06d(p=0.84); wound infection rate11.8%/13%（p=0.9）;pulmonary infection rate17.8%/13%（p=0.69); urinary system infectionrate11.8%/4.3%（p=0.38); theoretically discharge time postoperation13.64±3.35d/12.22±2.99d(p=0.44).Conclusions:Bevacizumab combined with neoadjuvant therapy was welltolerated in the treatment of middle and and low locally advanced rectalcancer, it did not obviously increase the adverse events of neoadjuvanttherapy and perioperation complications. However, the pCR rate, tumordown staging rate and sphincter preservation rate was not improved in thecomparison to the other trials that used FOLFOX in preoperativeradiochemotherapy.