抗血管药物治疗放射性脑坏死专家共识  

Expert Consensus on the Treatment of Antiangiogenic Agents for Radiation Brain Necrosis

作　　者：陈意 王鑫[2] 孙冰 孟茂斌 王恩敏 袁智勇 庄洪卿[1] 中国医药教育协会肿瘤放射治疗委员会 Yi CHEN;Xin WANG;Bing SUN;Maobin MENG;Enmin WANG;Zhiyong YUAN;Hongqing ZHUANG;Society of Radiation Oncology,Chinese Medical Education Association(Department of Radiation Oncology,Peking University Third Hospital,Beijing 100191,China;Department of Radiation Oncology,Fudan University Huashan Hospital,Shanghai 200000,China;Department of Radiation Oncology,The Fifth Medical Center of PLA General Hospital,Beijing 100000,China;Department of Radiation Oncology,Tianjin Medical University Cancer Institute and Hos-pital,Tianjin 300000,China;不详)

机构地区：[1]北京大学第三医院肿瘤放疗科,北京100191 [2]复旦大学附属华山医院肿瘤放疗科,上海200000 [3]解放军总医院第五医学中心肿瘤放疗科,北京100000 [4]天津医科大学肿瘤医院肿瘤放疗科,天津300000 [5]不详

出　　处：《中国肺癌杂志》2022年第5期291-294,共4页Chinese Journal of Lung Cancer

摘　　要：血管内皮生长因子(vascular endothelial growth factor,VEGF)的高水平表达是放射性脑坏死(cerebral radiation necrosis,CRN)发生的重要机制。抗血管生成药物(贝伐珠单抗)通过抑制VEGF,作用于脑坏死区域周围的血管组织,减轻CRN引起的脑水肿。许多研究证实贝伐珠单抗可有效缓解脑坏死症状,改善患者的体力状况评分以及减轻影像学上脑水肿范围。抗血管治疗的疗效主要与药物作用时长相关,低剂量抗血管药物即可达到较好的治疗效果。预防是最好的治疗,CRN的发生与肿瘤相关因素和治疗相关因素相关,通过控制两方面因素,可有效预防CRN。Vascular damage is followed by vascular endothelial growth factor(VEGF)expression at high levels,which is an important mechanism for cerebral radiation necrosis(CRN)development.Antiangiogenic agents(Bevacizumab)alleviates brain edema symptoms caused by CRN through inhibiting VEGF and acting on vascular tissue around the brain necrosis area.Many studies have confirmed that Bevacizumab effectively relieves symptoms caused by brain necrosis,improves patients’performance status and brain necrosis imaging.Considering that the efficacy of antiangiogenic therapy is mainly related to the duration of drug action,low-dose antiangiogenic agents can achieve favorable efficacy.Prevention is the best treatment.■e occurrence of CRN is associated with tumor-related factors and treatment-related factors.By controlling these factors,CRN can be effectively prevented.

关 键 词：放射性脑坏死 抗血管生成药物 贝伐珠单抗 专家共识 

分 类 号：R818.8[医药卫生—放射医学]