贝伐珠单抗联合地塞米松治疗脑胶质瘤放疗后瘤周脑水肿效果的初步对照研究  

Preliminary controlled study on the clinical effect of bevacizumab combined with dexamethasone in the treatment of peritumoral cerebral edema after radiotherapy for glioma

作　　者：马丽丽[1] 邱教学 孙超 陈继征 Ma Lili;Qiu Jiaoxue;Sun Chao;Chen Jizheng(Department of Neurology,Yantaishan Hospital,Yantai 264001,China;Department of Neurology,ZiBo Hospital of Shandong healthcare Group,Zibo 255120,China)

机构地区：[1]山东省烟台市烟台山医院神经内科,烟台264001 [2]山东颐养健康集团淄博医院神经内科,淄博255120

出　　处：《中华转移性肿瘤杂志》2023年第4期366-370,共5页Chinese Journal of Metastatic Cancer

摘　　要：目的比较贝伐珠单抗联合地塞米松治疗脑胶质瘤放疗后瘤周脑水肿(PTBE)临床效果。方法选取我院2020年3月至2022年12月收治的54例脑胶质瘤放疗后PTBE患者进行回顾性研究,将患者按随机数字表法随机分为两组,各27例。对照组采用地塞米松治疗,研究组在此基础上加用贝伐珠单抗治疗。比较两组疗效,QLQ-C30与MoCA评分,脑水肿带的平均宽度、指数、体积和不良反应。结果治疗6周后,研究组总有效率高于对照组(85.19%∶59.26%,P<0.05)。研究组QLQ-C30与MoCA评分高于对照组[(30.61±4.21)分∶(17.23±3.79)分与(24.32±2.78)分∶(16.45±2.71)分,均P<0.05],NIHSS评分、脑水肿带平均宽度、指数、体积低于对照组[(6.54±1.23)分∶(9.04±1.11)分、(2.87±0.41)cm∶(3.24±0.37)cm、(5.53±1.51)分∶(7.35±1.47)分、(130.02±39.89)cm^(3)∶(231.46±42.71)cm^(3),均P<0.05]。两组不良反应总发生率相近(研究组14.81%∶对照组18.52%,P>0.05)。结论贝伐珠单抗联合地塞米松治疗脑胶质瘤放疗后PTBE临床效果显著,可能有效减少脑水肿,改善神经功能、认知功能、生活质量且不增加不良反应,但还需大样本研究加以证实。Objective To compare the clinical efficacy of bevacizumab(BEV)combined with dexamethasone in the treatment of peritumoral cerebral edema(PTBE)after radiotherapy for glioma.Methods A retrospective study was conducted on 54 patients with glioma treated with PTBE after radiotherapy in our hospital from March 2020 to December 2022.The patients were randomly divided into two groups according to a random number table method,with 27 cases in each group.The control group was treated with dexamethasone,and the study group was treated with BEV and dexamethasone.The scores of QLQ-C30 and MoCA,average cerebral edema bands width,index,volume and adverse reactions were compared between the two groups.Results After 6 weeks of treatment,the total effective rate in the study group was higher than that in the control group(85.19%vs 59.26%,P<0.05).The scores of QLQ-C30 and MoCA in the study group were higher than those in the control group[(30.61±4.21)points vs(17.23±3.79)points and(24.32±2.78)points vs(16.45±2.71)points,both P<0.05].The NIHSS score,average width,index,and volume of brain edema bands were lower than those in the control group[(6.54±1.23)points vs(9.04±1.11)points,(2.87±0.41)cm vs(3.24±0.37)cm,(5.53±1.51)points vs(7.35±1.47)points,(130.02±39.89)cm^(3),vs(231.46±42.71)cm^(3),all P<0.05].The total incidence of adverse reactions in the two groups was similar(14.81%in the study group vs 18.52%in the control group,P>0.05).Conclusions The clinical effect of BEV combined with dexamethasone in the treatment of PTBE after radiotherapy for glioma may be significant,effectively reducing cerebral edema improving neurological function,cognitive function,and quality of life,and has a certain degree of safety.However,it still needs to be confirmed by a large sample study.

关 键 词：脑胶质瘤 瘤周脑水肿 贝伐珠单抗 地塞米松 

分 类 号：R739.41[医药卫生—肿瘤]