| Background:Colorectal cancer（CRC）is one of the common malignancies in the abdomen.CRC accounts for 10% of the total incidence of malignant tumors,ranking 3rd in the world,and 9.4% of the total mortality from cancer,ranking 2rd according to the latest global cancer report released by WHO in 2020.The most common target organ for CRC hematogenous metastases is the liver,and colorectal cancer Liver metastases（CRLM）are the main cause of prognosis in CRC patients.The incidence of CRLM is 30-50% of CRC,with concurrent liver metastases accounting for about 15-25% and heterochronic liver metastases for about15-25% of patients.The other 80%-90% of patients with unresectable liver metastases can be resected or have no evidence of disease（NED）after conversion therapy.Currently,surgical resection of liver metastases remains the key method to improve the prognosis of CRLM.Therefore,the conversion of initially unresectable CRLM to resectable CRLM through translational therapy is important to improve the overall survival（OS）and prognosis of CRC.At present,there are many schemes for the translational treatment of CRLM,Bevacizumab combined with first-line chemotherapy is considered to be an ideal scheme,but there is still a lack of relevant systematic evaluation conclusions on improving the resectable conversion rate and increasing the survival benefit of CRLM patients.Therefore,we conducted a meta-analysis to clarify the effects of bevacizumab in patients with CRLM.Aims:To assess the impact of bevacizumab plus first-line chemotherapy in patients with initial unresectable CRLM on the improvement of resectable conversion rate and survival benefit.Methods:We conducted search of Chinese and foreign language databases,including Pub Med,Cochrane Library,Embase,China Knowledge Network,Vipshop database,and Wanfang database using the search method of subject terms combined with free words,and used the strategy of searching the whole database to search for studies on the translational treatment of patients with colorectal cancer liver metastases with bevacizumab combined with first-line chemotherapy between the establishment of the database and December 2021,and browse the relevant references of the relevant reviews,and manually search if necessary.Relevant inclusion and exclusion criteria were developed to determine the final included literature,basic information of included studies was extracted,and data processing was performed using statistical software such as Rev Man 5.4 and stata16 to conduct a meta-analysis of the value of bevacizumab combined with first-line chemotherapy on translational therapy for patients with colorectal cancer liver metastases.Results:A total of nine clinical studies were included,including five single-arm studies and four RCTs,with a total of 612 patients based on relevant inclusion and exclusion criteria.The results showed that the addition of bevacizumab to chemotherapy（FOLFOX、FOLFOXIRI）in patients with CRLM significantly increased the R0 resection rate（RR=0.29,95%CI: 0.21-0.38）,ORR（RR=0.56,95% CI: 0.39-0.72）,conversion resection rate（Chemo+Bevacizumab vs Chemo only）（RR=2.41,95% CI:0.98-5.88）,significantly improved survival benefits,including progress free survival（PFS）and OS（HR=0.55,95%CI:0.41-0.73;HR=0.69,95%CI: 0.54-0.88）.Conclusions:Bevacizumab combined with first-line chemotherapy can significantly improve the conversion resection rate and survival benefit of patients with initially unresectable CRLM.Bevacizumab has shown important clinical significance and application value in the translational treatment of patients with initially unresectable CRLM. |
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