Comparative analysis of the effectiveness of bevacizumab plus FOLFIRI regimen in the treatment of microsatellite stable type,advanced left-sided and right-sided colorectal cancer
Objective To explore the difference in the effectiveness of bevacizumab combined with FOLFIRI regimen for the treatment of microsatellite stable(MSS)type,advanced recurrent left-sided and right-sided colorectal cancer.Methods A total of 58 patients who were admitted to the Affiliated Hospital of Xuzhou Medical University from September 2018 to December 2021 due to MSS-type advanced recurrent left-sided and right-sided colorectal cancer and treated with first-line bevacizumab plus FOLFIRI regimen were selected,and their clinical data were retrospectively analyzed.Their clinical characteristics,overall survival time(OS),progression-free survival(PFS),disease control rate(DCR),objective remission rate(ORR),and 1-and 2-year survival rates were compared.Results The proportion of MSS-type advanced right-sided colorectal cancer patients with combined incomplete bowel obstruction was higher(P<0.05).MSS-type advanced right-sided colon cancer patients were more likely to have combined anemia and weight loss>5 kg than left-sided colorectal cancer patients(both P<0.05).The proportion of right-sided colon cancer patients with a maximum tumor diameter of≥5 cm was higher than that of left-sided colorectal cancer patients(P<0.05).The proportion of male patients in left-sided colorectal cancer patients was lower than that of right-sided colon cancer patients(P<0.05).After treatment,both groups showed remarkable decreases in carcinoembryonic antigen(CEA)and glycan antigen 199(CA199),compared with those before treatment(P<0.05).The proportion of patients who developed liver metastasis was higher in the right-sided colon cancer group than that in the left-sided colorectal cancer group(P<0.05).The ORR in the left-sided and the right-sided colorectal cancer groups was 14.8%and 29.0%,respectively(P>0.05),and the DCR was 74.1%and 87.1%(P>0.05),respectively.The 1-and 2-year survival rates were 92.6%and 81.4%in the left-sided colorectal cancer group and 83.8%and 61.3%in the right-sided colon cancer group,respectively(P<0.05).The left-sided colorectal cancer group presented better median PFS than the right-sided colon cancer group,with better prognosis(13.7 months vs 10.1 months,P<0.05).The median OS in the left-sided colorectal cancer group was also significantly better than that in the right-sided colon cancer group(35.3 months vs 27.2 months,P<0.05).Conclusions The application of bevacizumab plus FOLFIRI regimen for the treatment of patients with MSS-type advanced recurrent colorectal cancer brings about differences in clinical features,metastatic sites and survival between the left-sided and right-sided colorectal cancers.
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