Purpose: To observe the efficacy and side effects of combined treatment of bevacizumab and 5-fluorouracil in patients with metastatic colon cancer.
Methods: Sixty patients with histopathologically confirmed metastatic colon cancer were treated with bevacizumab and 5-fluorouracil (the study group) or 5-fluorouracil alone (the control group). 400 mg/m2 5-fluorouracil was given intravenously and maintained by a micropump (2400 mg/m2) for 46 hrs. A treatment cycle consisted of 14 days. All patients received at least 4 cycles of treatment. Serum vascular endothelial growth factor (VEGF) concentrations in colon cancer patients of the two groups were evaluated before and after chemotherapy. The short-term treatment efficacy was assessed and followed every 3 months for survival analysis, while adverse reactions were also observed and recorded.
Results: Before the treatment, no differences were observed in VEGF levels between the two groups. However, after 4 cycles of chemotherapy, VEGF level in the study group was markedly lower vs the pretreatment level. No difference was observed in VEGF level in the control group after treatment. The effective rate in the two groups after treatment was response rate (RR)=86.7% and 53.3%, respectively (p<0.05). A 24-month follow-up showed that the median progression-free survival (PFS) of the study group was 9.87 months and the median survival 16.9 months. The median PFS of the control group decreased to 6.75 months with median survival of 12.45 months. Data analysis showed significant differences in PFS and median overall survival (OS) between the two groups (p<0.05). Besides, no difference was observed in the adverse reactions between the two groups during treatment (all p>0.05).
Conclusions: Combined treatment of bevacizumab and 5-fluorouracil can reduce the serum VEGF level of patients with metastatic colon cancer and prolong their PFS and OS.