Khảo sát hiệu quả và tính an toàn phác đồ có bevacizumab trong điều trị ung thư đại - trực tràng di căn tại Bệnh viện Nhân dân Gia Định

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Tác giả: Đặng Đăng Khoa Hồ, Bá Thảo Lê, Kiều Sương Liên, Ngọc Khôi Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại: 959.7 Vietnam

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 60-65

Bộ sưu tập: Metadata

ID: 498777

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Khảo sát hiệu quả và tính an toàn của phác đồ hóa trị phối hợp bevacizumab trên bệnh nhân ung thư đại trực tràng di căn (UTĐTDC). Phương pháp: Nghiên cứu hồi cứu, mô tả cắt ngang tất cả các trường hợp bệnh nhân UTĐTT di căn tại Bệnh viện Nhân Dân Gia Định từ tháng 1/2018 - 10/2020. Kết quả: Dựa trên phân tích 80 hồ sơ bệnh án hóa trị, các đặc điểm chính của bệnh nhân bao gồm: 58,8% nam, tuổi trung vị 60,6
bệnh nhân có điểm toàn trạng ECOG ≥1 chiếm 82,5%. Phác đồ hóa trị bao gồm capecitabine + oxaliplatin (58,7%)
5-fluorouracil/ leucovorin (5-FU/LV) + oxaliplatin (11,3%), irinotecan + 5-FU/LV (8,8%), capecitabin đơn trị (13,7%)
các phác đồ khác (7,5%). Trong thời gian theo dõi là 33 tháng, khảo sát trên 644 chu kì hóa trị có bevacizumab, ghi nhận trung vị thời gian đến khi điều trị thất bại 14,6 tháng (95%CI, 12,6 - 16,6). Không ghi nhận các biến cố thủng đường tiêu hóa, protein niệu, cơn tăng huyết áp cấp cứu, thuyên tắc mạch trên hồ sơ bệnh án. Tuy nhiên, có 2 bệnh nhân ghi nhận xuất huyết đường tiêu hóa (2,5%), mức độ nhẹ không cần phải ngưng hoặc trì hoãn điều trị bevacizumab. Ngoài ra, có ghi nhận một số biến cố bất lợi nghiêm trọng mức độ 3-4: giảm bạch cầu hạt, tiêu chảy, bệnh thần kinh ngoại vi và thiếu máu với tần suất tương ứng là 8,75%, 2,5%, 2,5% và 2,5%. Kết luận: Bevacizumab phối hợp hóa trị cho tính an toàn dung nạp và hiệu quả tương tự với các nghiên cứu lâm sàng đã được báo cáo. Tuy nhiên phải theo dõi chặt chẽ trong quá trình điều trị để hạn chế và xử lý các tác dụng bất lợi nghiêm trọng như giảm bạch cầu hạt.This study was designed to evaluate the eficacy and safety of bevacizumab-containing chemotherapy. Methods: Cross-sectional description was carried on metastatic colorectal cancer patient in Nhan Dan Gia Dinh Hospital from January 2018 to October 2020. Results: The final analysis comprised of 80 patients (male 58.8%
median age 60.6 years and 82.5% had an Eastern Cooperative Oncology Group performance status score ≥1 Chemotherapy included capecitabine plus oxaliplatin (58.7%)
5-fluorouracil/leucovorin (5-FU/LV) + oxaliplatin (11.3%), irinotecan plus 5-FU/LV (8.8%), capecitabine monotherapy (13.7%) and others (7.5%). The median follow - up was 33 months and analysis based on 644 cycles of anticancer therapy including bevacizumab. Median time to treatment failure was 14.6 months (95% confidence interval 12.6 - 16.6). No GI perforations, proteinuria, hypertension crisis, venous thromboembolic events were identified. However, two GI bleeding events occurred (2.5%), no requiring discontinuation of bevacizumab. In addition, grades 3 and 4 febrile neutropenia, diarrhea, peripheral neuropathy and anemia showed cumulative incidences of 8.75%, 2.5%, 2.5% and 2.5%, respectively. Conclusion: Bevacizumab in combination with chemotherapy appears to be well tolerated, and efficacy is consistent with other trial reports. However, patients should be closely monitored to avoid potentially serious events such as neutropenia.

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