贝伐珠单抗治疗肺癌脑转移伴难治性瘤周水肿的疗效观察  

Observation on clinical efficacy of bevacizumab in treatment of lung cancer brain metastasis complicated with refractory peritumoral edema

作　　者：张欢欢[1,2] 岳文[1] 付艳[2] 李晓松[2] 杜楠[2] 

机构地区：[1]军事医学科学院野战输血研究所,北京100039 [2]解放军总医院第一附属医院肿瘤二科,北京100048

出　　处：《川北医学院学报》2017年第2期178-181,共4页Journal of North Sichuan Medical College

摘　　要：目的:观察贝伐珠单抗治疗肺癌脑转移伴难治性瘤周水肿的疗效及不良反应。方法:回顾性分析接受贝伐珠单抗治疗的24例伴瘤周水肿的肺癌脑转移患者的临床资料,评估患者在贝伐珠单抗治疗前后的临床症状、生活质量评分(KPS)及MRI T2像显示的水肿体积,记录相关不良反应。结果:经贝伐珠单抗治疗后,18例患者头晕、头痛等症状明显减轻,6例症状改善不明显。KPS评分均高于治疗前[(63.75±12.45)vs.(76.7±10.5),P<0.05)],瘤周水肿体积较治疗前明显减小,瘤周水肿指数EI较治疗前降低[(12.09±10.75)vs.(4.45±4.28),P<0.05)]。24例患者中有4例出现鼻衄,2例痰中带血,2例胃部不适,1例高血压,1例便血,未出现蛋白尿、严重出血、胃肠道穿孔等其他不良反应。结论:贝伐珠单抗可控制肺癌脑转移的难治性瘤周水肿,为严重脑水肿患者争取治疗及生存机会,但应谨慎掌握适应证及剂量,警惕严重不良反应。Objective To observe the clinical efficacy and adverse reactions of bevacizumab in the treatment of lung cancerbrain metastasis complicated with refractory peritumoral edema. Methods：The clinical data of 24 patients with lung cancer brain metastasiscomplicated with refractory peritumoral edema who received bevacizumab were retrospectively analyzed to evaluate the clinical efficacy, quality of life （QOL） score and edema volume in magnetic resonance imaging （M R I） T2 images before and after treatment withBevacizumab, and to record related adverse reactions. Results ： After treatment with bevacizumab, 18 patients had symptoms like vertigoand headache relieved, and 6 had insignificant improvement. Karnofsky performance scoring （KPS） score was notably higher after treatmentthan treatment before [ （63. 75 ± 12. 45 ） vs （76. 7 ± 10. 5 ） , P 〈 0. 05 ） ] . Peritumoral edema size decreased prominently thantreatment before while peritumoral edema index （E l） decreased [ （12. 09 ± 10. 75） vs （4. 45 ± 4. 2 8 ） , P 〈 0 . 0 5 ） ] . Of the 24 patients,4 had epistaxis,2 had blood in sputum, 2 had gastric discomfort, 1 had hypertension and 1 had hematochezia, but none had other adversereaction like proteinuria, sever hemorrhage, and gastrointestinal perforation. Conclusion ： Bevacizumab control the refractory peritumoraledema in patients with lung cancer brain m etastasis, and provide beneficial treatment and survival changes for patients with severe cerebraledema. But its indications and dosage should be cautiously mastered so as to avoid severe adverse reactions.

关 键 词：贝伐珠单抗 肺癌 脑转移瘤 瘤周水肿 

分 类 号：R730[医药卫生—肿瘤]