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[摘要]
目的 探讨贝伐单抗注射液联合卡培他滨片对晚期转移性直肠癌患者血清表皮生长因子受体(EGFR)及人表皮生长因子受体(HER)表达的影响。方法 回顾性分析2014年10月—2017年10月到内蒙古医科大学附属医院诊治的晚期转移性直肠癌的患者84例,随机数字表法分为两组。对照组(42例)患者口服卡培他滨片,2 000 mg/m2,分2次服用,连续给药2周。观察组(42例)患者在对照组治疗的基础上第1天静脉滴注贝伐珠单抗注射液7.5 mg/kg。3周为1个周期,疗程为8个周期。比较两组患者的疗效、无进展生存率、血清表皮生长因子受体(EGFR)及人表皮生长因子受体(HER)水平和生活质量评分。结果 治疗后,观察组患者化疗有效率和控制率分别为28.57%和59.52%,明显高于对照组患者的11.90%和38.10%,两组比较差异具有统计学意义(P<0.05)。治疗后,观察组患者6个月、1年和2年无进展生存率分别为92.85%、80.95%和59.52%,明显高于对照组患者的80.95%、57.14%和38.10%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组EGFR及HER水平均明显降低,同组治疗前后比较差异具有统计学意义(P<0.05);且观察组降低幅度明显大于对照组患者,两组比较差异具有统计学意义(P<0.05)。治疗后,两组物质生活、躯体功能、社会功能和心理功能评分均较治疗前有所降低,同组治疗前后比较差异具有统计学意义(P<0.05);但观察组患者各项评分降低幅度明显小于对照组,两组比较差异具有统计学意义(P<0.05)。治疗期间两组患者骨髓抑制、胃肠道反应、高血压、蛋白尿及鼻出血等不良反应发生率未表现出明显差异。结论 贝伐单抗注射液联合卡培他滨片能够有效延缓晚期转移性直肠癌患者病情进展,提高患者生活质量,且不增加不良反应发生率,建议临床推广应用。
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[Abstract]
Objective To explore the efficacy of Bevacizumab Injection combined with Capecitabine Tablets on expression of EGFR and HER in treatment of metastatic rectal cancer in advanced stage. Methods Patients (84 cases) diagnosed with metastatic rectal cancer in advanced stage in The Affilitated Hospital of Inner Mongolia Medical University from October 2014 to October 2017 were randomly divided into two groups. Patients (42 cases) in the control group were po administered with Capecitabine Tablets, 2 000 mg/m2 for twice, and patients were treated for 2 weeks. Patients (42 cases) in the observation group were iv administered with Bevacizumab Injection 7.5 mg/kg at first day on the basis of control group. 3 weeks as one cycle, and the course of treatment was 8 cycles. Efficacy, progression-free survival rates, serum EGFR and HER levels, and quality of life score in two groups was compared. Results After treatment, the effective rate and control rate of chemotherapy in the observation group were 28.57% and 59.52%, respectively, which were significantly higher than 11.90% and 38.10% in the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the progression-free survival rates at 6 months, 1 year and 2 years in the observation group were 92.85%, 80.95% and 59.52%, respectively, which were significantly higher than 80.95%, 57.14% and 38.10% of the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment,EGFR and HER levels in two groups were significantly reduced, and the difference was statistically significant in the same group (P<0.05). And the decrease of the observation group was significantly greater than that of the control group, and the difference between the two groups was statistically significant (P<0.05). After treatment, the scores of physical life, physical function, social function and psychological function in two groups were reduced, and the difference was statistically significant in the same group (P<0.05). And the sores in the observation group were significantly lower than those in the control group, and the difference between the two groups was statistically significant (P<0.05). During the treatment, the adverse reaction incidences of bone marrow suppression, gastrointestinal reaction, hypertension, proteinuria, and nosebleed in two groups showed no significant difference. Conclusion Bevacizumab Injection combined with Capecitabine Tablets in treatment of metastatic rectal cancer in advanced stage can efficiently delay the disease progression,improve patients' quality of life, and do not increase the incidence of adverse reactions,which has clinical popularization and application.
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