贝伐珠单抗治疗顽固性脑水肿的近期疗效评价  

Evaluation of the short-term efficacy of bevacizumab in the treatment of refractory cerebral edema

作　　者：刘媛媛 王锋 赵季忠 徐朋琴 顾培 夏小春 LIU Yuanyuan;WANG Feng;ZHAO Jizhong;XU Pengqin;GU Pei;XIA Xiaochun(Department of Radiotherapy,Nantong University Affiliated Tumor Hospital,Nantong,Jiangsu 226361,China)

机构地区：[1]南通大学附属肿瘤医院<南通市肿瘤医院>放疗科,江苏南通226361

出　　处：《医药前沿》2022年第35期11-14,共4页Journal of Frontiers of Medicine

基　　金：南通市科学技术局(指令性)科技计划项目(JC2021151)。

摘　　要：目的:评价贝伐珠单抗治疗顽固性脑水肿的近期疗效评价。方法:16例分析2020年11月—2022年11月南通市肿瘤医院头颈放疗科收治的16例运用贝伐珠单抗治疗顽固性脑水肿患者的临床资料,其中肺癌脑转移5例,脑胶质母细胞瘤9例,直肠癌2例。所有患者对常规渗透性利尿剂、利尿剂、皮质类固醇等治疗不敏感。贝伐珠单抗使用剂量为5 m g/k g。每3~4周重复,至少接受1次以上治疗。通过测量首次用药前、用药后两月、用药后四月的瘤周水肿及瘤体体积并计算水肿指数。记录患者用药前后临床症状及不良反应。结果:本研究16例患者中,所有患者使用贝伐珠单抗治疗后颅内压增高表现较用贝伐珠单抗治疗前改善,16例患者治疗后2个月的水肿指数(5.67±4.66)低于治疗前(8.11±6.47),差异有统计学意义(P<0.05);治疗后4个月的水肿指数(4.97±3.74)相比于治疗前(8.11±6.47)总体均数存在着统计差异(差值为3.14,P<0.05)。治疗过程中均无明显严重不良反应。结论:贝伐珠单抗可有效控制顽固性瘤周水肿,缓解临床症状,改善患者生活质量,为治疗脑恶性肿瘤伴有瘤周脑水肿的治疗提供了新思路。Objective To retrospectively study the short-term efficacy of bevacizumab in the treatment of patients with refractory cerebral edema.Methods The clinical data of 16 patients with refractory cerebral edema treated with bevacizumab from November 2020 to November 2022 in the head and neck radiotherapy department of Nantong Tumor Hospital were analyzed.including 5 cases of lung cancer brain metastasis,9 cases of glioblastoma and 2 cases of rectal cancer.All patients were insensitive to conventional osmotic diuretics,diuretics,corticosteroids and other treatments.Bevacizumab was administered at a dose of 5 mg/kg Repeating every 3 to 4 weeks,receiving at least one treatment.The edema around the tumor and the tumor volume were measured before the first drug,two months after the drug,and four months after the drug,and the edema index was calculated.The clinical symptoms and adverse reactions of patients before and after treatment were recorded.Results After treatment,the increased intracranial pressure in all patients was improved compared with that before the treatment.The edema index of all patients at 2 months and 4 months after treatment were significantly lower than that before the treatment(P<0.05).There were no obvious serious adverse reactions during the treatment.Conclusion Bevacizumab can effectively control intractable peritumoral edema,relieve clinical symptoms,and improve the quality of life of patients,providing a new idea for the treatment of brain malignant tumors accompanied by peritumoral brain edema.

关 键 词：贝伐珠单抗 脑恶性肿瘤 瘤周脑水肿 

分 类 号：R742[医药卫生—神经病学与精神病学]