Multivariate Analysis Of The Prognosis Of Chemotherapy Combined With Bevacizumab For Metastatic Colorectal Cancer At Different Metastatic Sites

Objective:Chemotherapy combined with bevacizumab is currently the first level recommended treatment for metastatic colorectal cancer,but some patients have been found to have disease progression after bevacizumab.Therefore,this study aimed to analyze factors that may influence the prognosis of metastatic colorectal cancer and the mechanisms that may cause bevacizumab resistance,mining possible predictors of therapeutic prognosis of metastatic colorectal cancer and predictors of bevacizumab resistance.Methods:1.Collect the relevant data of metastatic colorectal patients treated with bevacizumab through the medical record system of Zhujiang Hospital,and the collected patients were divided into two groups according to different tumor metastasis sites;2.Chi-square test and survival analysis of the disease remission rate and progression-free survival time of the two groups were conducted through SPSS 26.0 software;3.Different data of all patients were summarized and eliminated,and 13 different variables were selected into the COX regression model for multivariate analysis,and survival analysis of categorized variables according to the results of multivariate analysis.Results:1.For colorectal cancer patients with different initial metastatic sites,after systemic treatment with chemotherapy combined with bevacizumab,there is no statistical difference in disease control rate and no statistical difference in median progression-free survival time;this indicates that different metastatic sites have no effect on the systemic therapy of patients with metastatic colorectal cancer,and different metastatic sites will not affect the progression-free survival time of patients;2.The results of COX regression model constructed with 13 variables showed that serum CA199 level,LMR rate(lymphocyte to monocyte ratio)and PLR rate(platelet to lymphocyte ratio)before systemic therapy had statistically significant effects on progression-free survival time,suggesting that all three are risk factors for progression-free survival time in patients with metastatic colorectal cancer.3.patients with negative CA19-9 levels had an approximately 60%lower risk of survival relative to those with positive CA19-9 levels,It may be a predictive marker of treatment outcome in patients with metastatic colorectal cancer;The LMR rate results are inconsistent with those suggested by existing studies,This may suggest that in advanced metastatic colorectal cancer,The LMR rate does not reliably predict the patient’s disease outcome;In addition to suggesting a prognostic outcome in patients with metastatic colorectal cancer,Combined with the characteristics of elevated platelets in malignancy and their function in promoting angiogenesis in the tumor microenvironment,PLR rates may also play a role in driving the emergence of resistance in bevacizumab therapy.Conclusion:Different tumor metastatic sites had no effect on systemic systemic therapy and disease progression-free survival time in metastatic colorectal cancer patients;serum CA199 levels before systemic systemic therapy,LMR rate(lymphocyte to monocyte ratio),and PLR rate(platelet to lymphocyte ratio)can be considered predictors of progression-free survival time in metastatic colorectal cancer patients,where increased PLR rate may be related to the mechanism of resistance to bevacizumab therapy.