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目的：观察贝伐单抗二线治疗转移性结直肠癌患者的临床疗效和毒副反应。方法：回顾性分析2008 年8 月至2011 年10 月我院经组织病理学证实的转移性结直肠癌患者21 例，一线治疗进展后，二线治疗方案中加用贝伐单抗，用法为5mg/kg,每2-3 周 1 次,与化疗方案同步。化疗方案以奥沙利铂及伊立替康为基础，完成2-3 周期治疗后评定疗效，观察毒副反应。结果：21 例患者中 PR1 例,SD11 例,PD9 例，客观缓解率为4.8%，疾病控制率为57.1%，中位TTP 为3.7 个月。患者出现的不良反应有骨髓抑制、皮疹、恶心呕吐、腹泻、肝功能损害、神经毒性等，贝伐单抗所致高血压的发生率为14.3%（3/21），鼻衄发生率为4%（2/21）。结论：二线治疗中使用贝伐单抗，对一线治疗进展后的转移性结直肠癌疗效有限，毒副反应可耐受。

英文摘要:

Objective: To investigate the clinical efficiency and toxicity of bevacizumab on the second-line treatment of patients with metastatic colorectal cancer. Methods: From August, 2008 to October,2011,retrospective analysis of 21 cases with metastatic colorectal cancer were performed. All the diagnosis were confirmed by histopathology. Patients were treated with bevacizumab 5mg/kg every 2 to 3 weeks combined with irinotecan-based and oxaliplatin-based chemotherapy regimens after failure of the first-line treatment. The therapy effect and toxicity were evaluated after every two to three cycles. Results: In these 21 cases, the cases of PR,SD,PD were 1,11 and 9, the ORR (objective response rate) and DCR (disease control rate) were 4.8% and 57.1% and the mediant TTP （time to progression）was 3.7 months. The mainly adverse reactions of these patients were marrow suppression, exanthems, nausea and vomiting, diarrhea, liver damage and neurotoxicity. The incidence of bevacizumab-induced hypertension and epistaxis were 14.3%（3/21）and 4% （2/21）. Conclusion: The therapy effect of bevacizumab in the second-line treatment after the progression in patients with metastatic colorectal cancer was limited.The toxicity could be acceptable.

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