贝伐珠单抗静脉给药治疗复发性呼吸道乳头状瘤的临床初步报告  

Initial clinical report of intravenous administration of Bevacizumab in the treatment of recurrent respiratory papilloma

作　　者：赵梦圆 鲁媛媛 朱振文 张永辉 陈丽娟[1,2] 胡慧英 赵腾 王昊[1] 王雅婷 张思瑶[1] 吴婉娟 刘凯 于振坤 ZHAO Mengyuan;LU Yuanyuan;ZHU Zhenwen;ZHANG Yonghui;CHEN Lijuan;HU Huiying;ZHAO Teng;WANG Hao;WANG Yating;ZHANG Siyao;WU Wanjuan;LIU Kai;YU Zhenkun(Department of Otolaryngology Head and Neck Surgery,the Affiliated Beng Hospital of Nanjing Medical University,Nanjing,Jiangsu,210019,China;the Forth School of Clinical Medicine,Nanjing Medical University,Nanjing,Jiangsu,210029,China;Southeast University School of Medicine,Nanjing,Jiangsu,210003,China)

机构地区：[1]南京医科大学附属明基医院耳鼻咽喉头颈外科,江苏南京210019 [2]南京医科大学第四临床医学院,江苏南京2210029 [3]东南大学医学院,江苏南京210003

出　　处：《中国耳鼻咽喉头颈外科》2023年第3期177-180,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：江苏省卫健委重点项目(K2019015)。

摘　　要：目的分析应用贝伐珠单抗静脉给药治疗复发性呼吸道乳头状瘤(recurrent respiratory papillomatosis,RRP)患者的初步疗效,为RRP治疗提供新思路。方法回顾性分析2022年3月~9月于南京医科大学附属明基医院因RRP就诊并行贝伐珠单抗静脉给药治疗的11例患者临床资料,其中女2例(18.18%),男9例(81.82%),年龄2~44(15.82±13.36)岁。治疗前描绘瘤体范围(Mapping)及进行Derkay评分。具体给药方法:全身静脉给药,药物剂量为10 mg/kg混于100 ml生理盐水中,90 min静脉滴注,治疗后监测瘤体大小范围并重新进行Derkay评分,并记录药物不良反应。结果11例患者平均随访时间为1~6(3.5±1.83)个月。截止到目前,4例患者仍在接受贝伐珠单抗静脉给药治疗,5例现已接受手术治疗,2例失访。11例患者乳头瘤瘤体均有所缩小,Derkay评分改善。中位给药频次为3(1~6)次,治疗过程中1例患者出现经期改变,1例轻微腹痛及咯血,3例出现鼻出血。11例RRP患者应用贝伐珠单抗治疗前后Derkay评分明显改善,差异有统计学意义(t=6.754,P<0.0001)。结论贝伐珠单抗全身治疗可有效控制RRP的疾病进展。长期疗效及不良反应仍需观察,治疗方案需进一步探索和完善。OBJECTIVE To report the preliminary efficacy of intravenous bevacizumab in the treatment of 11 patients with recurrent respiratory papillomatosis(RRP)in our center,and to provide new ideas for RRP treatment.METHODS The clinical data of 11 patients with RRP who were treated with intravenous bevacizumab from March 2022 to September 2022 in the Affiliated BenQ Hospital of Nanjing Medical University were retrospectively analyzed,including 2 females(18.18%)and 9males(81.82%),with an average age of 2-44(15.82±13.36)years.The method of drug administration was systemic intravenous administration,the dose of drug was 10 mg/kg,mixed with 100 ml normal saline,intravenous drip for 90 minutes.After treatment,the tumor size was monitored and Derkay score was re-evaluated,and the adverse drug reactions were recorded.RESULTS The average follow-up time of the 11 patients was 1-6(3.5±1.83)months.Up to now,4 patients are still receiving intravenous bevacizumab therapy,5 patients have now received surgical treatment,and 2 patients have been lost to follow-up.After bevacizumab treatment,the size of the papilloma was reduced and the Derkay score was improved in all 11 patients.The median frequency of administration was 3 times(1-6 times).During the treatment,1 patient had menstrual changes,1 patient had mild abdominal pain and hemoptysis,and 3 patients had epistaxis.Derkay scores of 11 RRP patients were significantly improved after bevacizumab treatment,with statistical significance(t=6.754,P0.0001).CONCLUSION Bevacizumab can effectively control the progression of RRP.The long-term efficacy and adverse reactions still need to be observed,and the treatment regimen needs to be further explored and improved.

关 键 词：喉肿瘤 人乳头瘤病毒6 人乳头瘤病毒11 复发性呼吸道乳头状瘤 贝伐珠单抗 

分 类 号：R734[医药卫生—肿瘤]