转移性结直肠癌治疗中贝伐单抗相关性高血压的发生及意义  

Bevacizumab-induced hypertension in patients with metastatic colorectal cancer:Its incidence and clinical significance

作　　者：杨琳[1] 蒋月强[2] 梅齐[1] 陈元[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院肿瘤科,湖北省武汉市430030 [2]华中科技大学同济医学院附属同济医院老年科,湖北省武汉市430030

出　　处：《世界华人消化杂志》2012年第26期2525-2528,共4页World Chinese Journal of Digestology

基　　金：湖北省自然科学基金资助项目;No.2011CDB213~~

摘　　要：目的:观察贝伐单抗治疗转移性结直肠癌(metastatic colorectal cancer,MCC)中高血压的发生情况,评价其对贝伐单抗疗效的预测价值.方法:回顾性分析我院使用贝伐单抗联合化疗治疗的MCC患者中,不良反应高血压的发生、治疗及转归.根据是否发生贝伐单抗相关性高血压把患者分为两组,比较两组疾病控制率(disease control rate,DCR)和无进展生存时间(progression-free survival,PFS).结果:40例MCC患者使用贝伐单抗联合化疗治疗,高血压发生的中位时间为38d,发生率为17.5%(7/40),3级高血压发生率为5.0%(2/40),无4-5级高血压发生,降压治疗后血压均可控制.与未发生高血压患者比较,发生高血压患者的DCR更高(85.8% vs 60.1%,P=0.439),PFS(13 mo vs 8 mo,P=0.191)更长但未达统计学差异.结论:高血压为贝伐单抗治疗MCC中常见不良反应,大多为轻-中度,降压治疗效果好,但高血压未能显示出对贝伐单抗疗效的预测作用.AIM：To investigate the incidence and management of bevacizumab-induced hypertension in patients with metastatic colorectal cancer （MCC）, and to evaluate its relationship with response to bevacizumab. METHODS：MCC patients treated with bevacizumab and chemotherapy were retrospectively enrolled in this study. Focus was placed on the patients’ blood pressure, corresponding management and clinical outcome. Patients were divided into two groups according to the occurrence of bevacizumab-induced hypertension or not. The disease control rate （DCR） and progression-free survival （PFS） were compared between the two groups. RESULTS：In total, 40 MCC patients were treated with bevacizumab and chemotherapy. The median time from the initiation of bevacizumab to the beginning of hypertension was 38 days. The incidence of treatment-induced hypertension was 17.5% （7/40）. Two patients （5.0%） were classified to have grade 3 hypertension. No grades 4-5 hypertension occurred. Blood pressure was controlled well in 7 patients after corresponding treatment. Patients with bevacizumab-induced hypertension had better DCR （85.8% vs 60.1%, P = 0.439） and PFS （13 mo vs 8 mo, P = 0.191）, but there were no statistical differences between the two groups. CONCLUSION：In MCC patients treated with bevacizumab and chemotherapy, the incidence of treatment-induced hypertension is high. But most of cases are mild to moderate and respond well to proper treatment. Bevacizumab-induced hypertension is not predictive factor of response to bevacizumab.

关 键 词：转移性结直肠癌 靶向治疗 贝伐单抗 高血压 

分 类 号：R735.35[医药卫生—肿瘤] R544.1[医药卫生—临床医学]