贝伐单抗胸腔内注射治疗难治性双侧恶性胸腔积液12例疗效观察并文献回顾  

Efficacy of intrapleural Bevacizumab injection for treating bilateral refractory malignant pleural effusion：a report and literature review of 12 cases

作　　者：周承志[1] 秦茵茵[1] 欧阳铭[1] 李时悦[1] 陈荣昌[1] 钟南山[1] 

机构地区：[1]广州医科大学第一附属医院广州呼吸疾病研究所呼吸疾病国家重点实验室呼吸疾病国家临床研究中心,510120

出　　处：《中华生物医学工程杂志》2015年第2期158-164,共7页Chinese Journal of Biomedical Engineering

基　　金：十二五国家科技支撑计划课题（2013BA109809）

摘　　要：目的：探讨贝伐单抗治疗难治性双侧恶性胸腔积液的疗效。方法收集2012年1月至2013年1月广州医科大学第一附属医院广州呼吸疾病研究所收治的12例难治性双侧恶性胸腔积液患者，所有患者一侧胸腔积液经过胸膜黏连治疗后胸水控制，另一侧在全身治疗基础上，经过至少一种非黏连手段处理后胸腔积液不能控制。所有患者均采取胸腔内注入贝伐单抗的方法，观察其疗效和不良反应。结果12例患者治疗后，7例达到部分缓解（PR）、5例为疾病稳定（SD），有效率为58.3%（7/12），疾病控制率为100%（12/12）。主要不良反应为短暂低热（16.67%，2/12），所有患者均可以耐受，无需特殊处理。结论对于难治性双侧恶性胸腔积液，一侧采用常规胸膜黏连术，另一侧采取胸腔内注入贝伐单抗进行治疗，不仅能够使胸腔积液得到控制，而且避免了由于双侧胸腔同时黏连所致的限制性通气功能障碍，临床疗效较好，不良反应少。Objective To investigate the efficacy of Bevacizumab for treating bilateral refractory malignant pleural effusion. Methods Twelve patients with bilateral refractory malignant pleural effusion, who were hospitalized in Guangzhou Institute of Respiratory Disease,First Affiliated Hospital of Guangzhou Medical University between January 2012 and January 2013 were included in the study. For all patients,the unilateral pleural effusion was controlled after pleurodesis,but the contralateral pleural effusion was not controlled by treatments other than pleurodesis based on systemic therapy. All patients received intrapleural Bevacizumab injection, and the efficacy and adverse reactions were determined. Results After the treatment in the 12 cases,7 were partial remission（PR）and 5 were stable disease（SD）,with the effective rate of 58.33%（7/12）and the disease control rate of 100%（12/12）. The main adverse reaction was transient low-grade fever（16.67%,2/12）. All patients could tolerate without special treatments. Conclusion For bilateral refractory malignant pleural effusion,unilateral pleural effusion can be controlled by conventional unilateral pleurodesis and contralateral intrapleural Bevacizumab injection. Also,the restrictive ventilatory dysfunction induced by bilateral pleural adhesion can be avoided,with good clinical efficacy and less adverse reactions.

关 键 词：血管内皮生长因子 贝伐单抗 胸腔积液 恶性 

分 类 号：R730.53[医药卫生—肿瘤]