Zhang Ninggang, Wang Yusheng, Li Xiuxiu, Song Xuefeng, Wen Lu
2017, 19(5): 346.
ObjectiveTo summarize the situations and characteristics of adverse drug reactions (ADR) of bevacizumab (Bev) combined with chemotherapy in treatment of advanced colorectal cancer.MethodsThe medical data of the patients with advanced colorectal cancer who received Bev combined with chemotherapy in Shanxi Tumor Hospital from April 2010 to December 2016 were collected for retrospective analysis. The sexual distinction, age, therapeutic regimen, time of using Bev, types and grades of adverse reactions which were related to chemotherapy and Bev respectively, the time from medication to appearance of ADR, and the patients′ outcomes were comparied.ResultsA total of 83 patients were enrolled in the study. Of them, 39 were males and 44 were females. Fifty-eight cases were <65 years old, 25 cases were ≥65 years old. There were 43 patients with colon cancer and 40 patients with rectal cancer. Forty-five patients received the treatment with Bev combined with first-line chemotherapy, and the number of cases who received mFOLFOX, FOLFIRI and fluorouracil were 18, 22 and 5, respectively. Thirty-eight patients received the treatment with Bev combined with second-line chemotherapy, and the number of cases receiving mFOLFOX, FOLFIRI and fluorouracil were 9, 19 and 10, respectively. Of 83 patients, 71 patients developed totally 152 case-times ADRs which were related to chemotherapy drugs, among them 31 patients developed 31 case-times ADRs related to Bev. The incidences of ADRs associated with chemotherapy drugs and Bev were 85.5% and 37.3%, respectively. The forenamed proportions were 83.1% (152/183) and 16.9% (31/183) respectively in the total case-times of ADRs. The top five incidences of ADRs associated with chemotherapy drugs were bone marrow suppression (59.0%, 49/83), nausea and vomiting (51.8%, 43/83), fatigue (19.3%, 16/83), peripheral neuritis (15.7%, 13/83) and abnormal liver function (10.8%, 9/83), successively. The proportions of levels of I, II, III and IV of ADRs were 28.2% (20/71), 36.6% (26/71), 23.9% (17/71) and 11.3% (8/71), respectively. The highest incidence of ADRs associated with Bev was hypertension (13.3%, 11/83), after that the incidences were hemorrhage (12.0%, 10/83), thrombosis (6.0%, 5/83), intestinal perforation (2.4%, 2/83), proteinuria (2.4%, 2/83) and wound healing syndrome (1.2%, 1/83), successively. The proportions of levels of Ⅰ, Ⅱ, Ⅲ and Ⅳ of ADR were 58.1% (18/31), 19.4% (6/31), 16.1% (5/31) and 6.5% (2/31), respectively. The ADRs related to the chemotherapy drugs appeared on day 1-115 after medications, the proportion of less than or equal to 3 months were 73.2% (52/71). The ADRs related to Bev appeared on day 5-130 after medications, the proportion of less than or equal to 3 months were 87.1% (27/31). The results of stratification analysis of gender, age (<65 years old and ≥65 years old), using time (first-line or second-line chemotherapy), cumulant of Bev (≤6 periods and >6 periods), and combined with different chemotherapy regimens (mFOLFOX, FOLFIRI and fluorouracil) showed that there were no significant differences between the incidences of ADRs related to chemotherapeutic drugs and Bev among the groups of different clinical features. The proportion of levels III and IV ADRs related to chemotherapeutic drugs were higher than those of Bev combining with single drug regimen of 5-FU (P<0.05). There were no significant differences in ADR level distributions of chemotherapeutic drugs and Bev in other clinical features groups (all P＞0.05).ConclusionsThe main ADRs caused by Bev combined with different chemotherapies in treatment of advanced colorectal cancer are ADR related to chemotherapeutic drugs. The ADRs associated with chemotherapeutic drugs and Bev are level Ⅰ-Ⅱ mainly and had better safety.
