| Objects to retrospectively analyzethe clinical pathological data of 120 mCRC patients with first-line treatment in Our department, and compare the curative effect and prognosis between bevacizumab combined with chemotherapy group and chemotherapy alone group. Test the concentration changesof the serum IL-8, VEGF-A, VEGFR-2, sTRAILbefore and after treatment respectively. Analyze the relationship between various cytokines and clinical pathologic features, chemotherapy curative effect and prognosisassociated with mCRC,to selectthe effective index which can predict the curative effect and prognosis of bevacizumab.Methods Collect 120 metastatic colorectal cancer patients receiving first-line chemotherapy during January 2011 to December 2013 in our hospital oncology department unit 2, and divide all the patients into the beacizumab group and chemotherapy groupaccording to different treatment methods.Test the concentration changes of the serum IL-8, VEGF-A, VEGFR-2, sTRAIL before and after treatment respectively using ELISA, and have statistical analysis with SPSS21.0. Compare the concentration changes of the serum IL-8, VEGF-A, VEGFR-2, sTRAIL before and after treatment respectively in all the patients. Compare the serum levels of cytokinesbefore and after treatmen in different treatment groups and between the effective and ineffective group in beacizumab group, and analyzethe relationship between cytokines and the clinical pathological features and the curative effect and prognosis of bevacizumab.Results 1. By the end of the follow-up on March 30,2015, in all patients accepted 6-weekfirst-line treatment,44 patients reached PR (36.7%),57 patients had SD (47.5%),19 patients got PD (15.8%), RR was 36.7%, the DCR was 84.2%.55 patients in the bevacizumab group and 32 cases (58.1%) reached PR,18 cases (32.7%) had SD, and 5 cases (9.1%) got PD, RR was 58.1%, the DCR was 90.9%.65 patients inchemotherapy group,12 cases (18.5%) reached PR,39 cases (60%) had SD,14 cases (21.5%) got PD, RR was 18.5%, the DCRwas 78.5%.2. Of the 120 patients,110 cases (91.7%) got disease progression (PD),64 cases (53.3%) died.Median PFS was 8.9 months and the median OS was 30.6 months.The median PFS was 11.2 months and the median OS was 33.9 monthsin the bevacizumab group;the median PFS was 7.9 months and the median OS was 28.1 months in the chemotherapy group.3. The serum IL-8, VEGF-A, VEGFR-2, sTRAIL concentrations were 0.187+/-0.20 ng/ml,306.09+/-36.70 pg/ml,2.23+/-0.48 ng/ml,903.69+/-132.23 pg/ml in 120 patients before the first-line treatment;After 6-week chemotherapy,the serum IL-8, VEGF-A, VEGFR-2, sTRAIL concentrations were 0.113+/-0.11 ng/ml,222.65+/-52.39 pg/ml,1.53+/-0.54 ng/ml,1132.29+/-193.19 pg/ml.By nonparametric 2 related sample test results:the serum IL-8, VEGFA, VEGFR-2 concentration is reducedafter the chemotherapy, and the differenceswere statistically significant before and after the treatment; The serum sTRAIL concentration was elevatedafter chemotherapy and the differences were statistically significant (P< 0.05).This suggests that the serum IL-8, VEGF-A, VEGFR-2, sTRAIL concentration changes were associated with the chemotherapy.4. By SPSS nonparametric two independent sample test, the result shows:the serum IL-8, VEGF-A, VEGFR-2, sTRAIL concentrations were not statistically differet between bevacizumab group and chemotherapy group before treatment,butthe serum IL-8、VEGF-A, VEGFR-2 concentration in the bevacizumab group were lower than the chemotherapy group, but the sTRAIL concentration were higher than the chemotherapy group, and the difference was statistically significant.It shows that serum IL-8, VEGF-A, VEGFR-2, sTRAIL concentration changeswere more related tobevacizumab.(P< 0.05was statistically significant)5. Dividethe bevacizumab group into effective group (CR+PR) and ineffective group (SD+PD)according to the curative effect of evaluation, compared the serum IL-8, VEGF-A, VEGFR-2, sTRAILconcentration changesserum IL-8, VEGF-A, VEGFR -2, sTRAIL concentration changes inthe two groups before treatment and 6-week after treatment.After two independent samples nonparametric test results:the serum IL-8, VEGF-A concentration were lowerafter treatment in the effectivegroup than that in the ineffective group, and VEGFR-2, sTRAIL concentration werenot significantly different beteen the effective group and the ineffective group,which suggesting that the serum IL 8, VEGF-A concentration changes were more associated with bevacizumab, and VEGFR-2, sTRAIL concentration has nothing to do with bevacizumab.(P< 0.05 was statistically significant)6. Make a further analysis of the concentration of serum cytokine changes with the prognosis of bevacizumab.Divided all the patients into higher and lower groupaccording to the serum IL-8, VEGF-A, VEGFR-2, sTRAIL concentration changes before and after treatment, make the single factor of survival analysis about PFS and OS, the result shows:the serum IL-8, VEGF-A, VEGFR-2 levels were notstatistically differentin the higher and lower group after 6-week first-line therapybetween the median PFS and OS, buthiger serum sTRAIL concentration group had a longer mPFS and mOS comparing withlower group.Therefore, the serum sTRAIL concentration changebefore and after treatment in patients may be able to predict the prognosis of bevacizumab, while the serum IL-8, VEGF-A, VEGFR-2concentration changes bevacizumab make little sense to predictPFS and OS.Conclusions 1.Compared with the chemotherapy,the application of bevacizumab in first-line chemotherapyto patients with metastatic colorectal cancer can significantly improve RR, and extend the mPFS and mOS.2. The serum IL-8, VEGF-A, VEGFR-2, sTRAIL concentration changes were statistically significant before and after treatment in the 120 patients with mCRC.3.The serum IL-8, VEGF-A concentration changes were more associated withcurative effect ofbevacizumab;4. The serum VEGFR-2, sTRAIL concentration has nothing to do with curative effect of bevacizumab.5. The serum sTRAIL concentration change before and after treatment in patients may be able to predict the prognosis of bevacizumab, while the serum IL-8, VEGF-A, VEGFR-2 concentration changes bevacizumab make little sense to predict PFS and OS. |
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