立体定向放射治疗联合贝伐珠单抗治疗脑转移瘤的临床研究  

Stereotactic radiotherapy with bevacizumab for brain metastases

作　　者：潘绵顺[1] 李勇[1] 邱书珺[1] 郭裕天[1] 邵显军 张丽[1] 张国禹 诸葛风华 

机构地区：[1]武警上海市总队医院武警部队肿瘤放射诊疗中心,上海201103

出　　处：《立体定向和功能性神经外科杂志》2017年第5期275-279,共5页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：立体定向放疗设备应用评价研究项目(编号:2017YFC00113700);武警上海市总队医院科研课题专项(编号:2014KY11)

摘　　要：目的研究立体定向放射治疗(SRT)联合贝伐珠单抗治疗脑转移瘤的有效性及安全性。方法回顾性总结SRT联合贝伐珠单抗治疗的脑转移瘤患者49例(肺癌脑转移瘤患者38例,乳腺癌脑转移瘤患者5例,肠癌脑转移瘤患者6例),并与同期78例(肺腺癌脑转移瘤患者60例,乳腺癌脑转移瘤患者12例,肠癌脑转移瘤患者6例)SRT联合激素和甘露醇治疗的传统药物组患者进行对比,分析两组患者的肿瘤缓解率、瘤周水肿的控制率、KPS评分的改善情况并对相关副作用进行评估。结果贝伐珠单抗组患者的近期(1~4周)肿瘤缓解率较传统药物组更有优势(χ~2=6.537,P=0.037);近期瘤周水肿控制率明显优于传统药物组(t=3.256,P<0.001),在快速获得的KPS评分提升的同时减少了甘露醇和激素的应用,药物相关性副作用较轻且可控。结论 SRT联合贝伐珠单抗治疗脑转移瘤能获得更高的近期肿瘤缓解率和瘤周水肿控制率,可能是治疗脑转移瘤的理想组合。Objective To evaluate the clinical efficacy of stereotactic radiotherapy with bev- acizumab for brain metastases. Methods Retrospective analysis of 49 patients withbrain metasta- seswhich have ever been treated by stereotactic radiotherapy withbevacizumab, and compare with the same period 78 patients which have ever been treated by stereotactic radiotherapy with corti- costeroids and mannitol. The response rate of the tumor, the control rate of the peritumoral ede- ma,the improvement of the KPS score and the side--effect were analyzed at last. Results Com- pared with the patients of the traditional drugs group, the patients of the bevacizumab group have better tumor response rate （x2=6. 537, P=0. 037） andperitumoral edema control rate （t=3. 256, P〈0. 001） after 1--4 weeks of SRT, theyachieved obvious KPS improvement with dosage reduc- tionof corticosteroids. The side--effectof bevacizumab is mild and controllable. Conclusion The better tumor response rate, peritumoral edema control rate and quality of life can be achieved when the brain metastaseswere treated by stereotactic radiotherapy with bevacizumab.

关 键 词：立体定向放射治疗 贝伐珠单抗 脑转移瘤 

分 类 号：R815[医药卫生—放射医学]