【摘要】 目的 探讨贝伐珠单抗联合奥沙利铂+亚叶酸钙+氟尿嘧啶（mFOLFOX6）方案治疗转移性结直肠癌的疗效及安全性。方法 将116例转移性结直肠癌患者按照治疗方法的不同分为单纯化疗组（62例，mFOLFOX6方案治疗）和联合组（54例，贝伐珠单抗联合m FOLFOX6方案治疗）。比较两组患者的临床疗效、血清学指标[血管内皮生长因子（VEGF）]、基质金属蛋白酶（MMP）、环氧合酶2(COX2)、白蛋白（ALB）、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表（EORTC QLQ-C30）]以及治疗过程中不良反应发生情况。结果 联合组患者的总缓解率明显高于单纯化疗组，差异有统计学意义（P﹤0.01）。治疗后，两组患者血清VEGF、MMP、COX2水平均较治疗前下降，且联合组患者血清VEGF、MMP、COX2水平均低于单纯化疗组，差异均有统计学意义（P﹤0.05）。治疗后，两组患者血清ALB、IgG、IgA水平均较治疗前下降，差异均有统计学意义（P﹤0.05）。治疗后，两组患者躯体功能、心理功能、物质生活、社会功能评分均较治疗前升高，且联合组患者躯体功能、心理功能、物质生活、社会功能评分均高于单纯化疗组，差异均有统计学意义（P﹤0.05）。两组患者各不良反应发生率比较，差异均无统计学意义（P﹥0.05）。结论 贝伐珠单抗联合mFOLFOX6方案治疗转移性结直肠癌相较于单纯化疗方案总缓解率较高，可通过降低血清VEGF、MMP、COX2水平抑制肿瘤新生血管生成，提高患者生活质量，且对免疫功能的影响较小，值得临床推广应用。更多还原

【Abstract】 Objective To investigate the efficacy and safety of bevacizumab combined with oxaliplatin+calcium folinate+fluorouracil(mFOLFOX6) regimen in the treatment of metastatic colorectal cancer. Method A total of 116 patients with metastatic colorectal cancer were divided into chemotherapy group(n=62, received mFOLFOX6 regimen) and combination group(n=54, received bevacizumab+mFOLFOX6 regimen) according to different treatment methods. The clinical efficacy, serum indicators[vascular endothelial growth factor(VEGF), matrix metalloproteinase(MMP), cyclooxygenase 2(COX2), albumin(ALB), immunoglobulin G(IgG) and immunoglobulin A(IgA)], quality of life [European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)], and adverse reactions during treatment were compared between the two groups. Result The overall response rate in the combination group was higher than that in the chemotherapy group(P<0.01). After treatment, serum VEGF, MMP and COX2 levels decreased in both groups, with lower levels in the combination group than those in the chemotherapy group(P<0.05). After treatment, serum ALB, IgG and IgA levels decreased significantly in both groups(P<0.05). After treatment, the scores of physical function, psychological function, material life and social function in both groups were increased, with higher scores in combination group than those in chemotherapy group(P<0.05). There were no statistical significance in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Bevacizumab+mFOLFOX6 regimen has higher overall response rate in patients with metastatic colorectal cancer, which can inhibit tumour angiogenesis by reducing serum VEGF, MMP and COX2 levels, improve patients’ quality of life, and has low impact on immune function.更多还原