摘要
目的探讨贝伐珠单抗治疗的转移性结直肠癌患者采取抗生素干预的临床效果。方法便利选取2019年8月—2021年8月收治的187例贝伐珠单抗治疗的结直肠癌患者进行回顾性分析,依据临床基础资料、抗生素的使用情况等因素进行生存汇总,并总结采取贝伐珠单抗治疗的临床效果,采取多因素分析后总结独立影响因素指标。结果采取生存分析后,单因素分析可知抗生素的使用、手术情况、BMI指数、ECOG评分与患者的总生存期相关(HR=2.12、1.49、0.26、1.74,P<0.05);多因素分析指标显示,抗生素的使用情况属于独立预测因子(P=0.008);采取贝伐珠单抗在一线、二线治疗中,患者是否使用抗生素与疾病控制率缓解率差异无统计学意义(P>0.05);一线治疗89例中的ORRn为25.8%,DCRn为89.9%,mPFS(11.33±2.25)个月,mOS(23.12±4.36)个月,患者的mPFS、mOS指标对比,差异有统计学意义(t=16.971、19.311,P<0.001);二线治疗的56例病例中,ORRn为10.7%,DCRn为69.6%,mPFS(12.12±1.25)个月,mOS(25.56±2.59)个月,患者的mPFS、mOS指标对比,差异有统计学意义(t=11.400、18.918,P<0.001)。结论在贝伐珠单抗治疗结直肠癌患者中应用抗生素后可缩短一线二线治疗患者的PFS和OS,主要是抗生素在肠道菌群中产生作用,从而改善患者的免疫功能,患者治疗期间因感染具备用药指征,需及时给予抗生素对症干预。
Objective To explore the clinical effect of antibiotic intervention in patients with metastatic colorectal cancer treated with bevacizumab.Methods 187 patients with colorectal cancer who were treated with bevacizumab between August 2019 and August 2021 were conveniently selected for retrospective analysis.Survival was summarized based on clinical basic data,antibiotic use and other factors,and the clinical effect of bevacizumab treatment was summarized,and independent influencing factors were summarized after multivariate analysis.Results After survival analysis,univariate analysis showed that the use of antibiotics,surgical conditions,BMI index,and ECOG score were associated with the overall survival of patients(HR=2.12,1.49,0.26,1.74,P<0.05).Multivariate analysis showed that antibiotic use was an independent predictor(P=0.008).Taking bevacizumab in the first-line and second-line treatment,there was no statistically significant difference between the use of antibiotics and the remission rate of disease control rate(P>0.05).Among the 89 patients treated with first-line treatment,the ORRn was 25.8%,the DCRn was 89.9%,the mPFS was(11.33±2.25)months,and the mOS was(23.12±4.36)months.There were statistically significant differences in the PFS and mOS indexes of the patients(t=16.971,19.311,P<0.001).Among the 56 cases of second-line treatment,the ORRn was 10.7%,the DCRn was 69.6%,the mPFS was(12.12±1.25)months,and the mOS was(25.56±2.59)months.There were statistically significant differences in the mPFS and mOS indexes of the patients(t=11.400,18.918,P<0.001).Conclusion The application of antibiotics in the treatment of colorectal cancer patients with bevacizumab can shorten the PFS and OS of patients with first-and second-line treatment,mainly because antibiotics play a role in the intestinal flora,thereby improving the immune function of patients.Because the infection has indications for medication,it is necessary to give antibiotics for symptomatic intervention in a timely manner.
作者
益东晋
YI Dongjin(Shengli Petroleum Administration Binhai Hospital,Dongying,Shandong Province,257237 China)
出处
《中外医疗》
2022年第14期95-98,120,共5页
China & Foreign Medical Treatment
关键词
贝伐珠单抗
转移性结直肠癌
抗生素
临床效果
多因素分析
Bevacizumab
Metastatic colorectal cancer
Antibiotics
Clinical effect
Multivariate analysis
