贝伐单抗维持治疗脑转移瘤疗效及安全性探析.docVIP

贝伐单抗维持治疗脑转移瘤疗效及安全性探析 　　摘要：目的 评估贝伐单抗治疗全脑放疗后复发或进展脑转移瘤的临床疗效。方法 回顾分析放疗后进展或复发脑转移瘤患者21例，共计28处病灶。患者有原发肿瘤病史且均取得病理，病灶均同时满足以下各项影像学证据：CT或MRI增强病灶表现为灶内强化且伴有明显水肿影；所有患者均给予贝伐单抗5 mg/kg，每14 d重复1次，治疗4～8个周期。每4周期治疗后第5周期治疗前均行MRI检查，比较治疗前后T1WI相增强病灶大小变化及T1WI相病灶水肿变化。记录患者治疗前、后临床症状、kps评分改变情况，治疗前、后病灶大小、水肿变化以及KPS评分行t检验。结果 21例患者均安全完成治疗，未见明显严重不良反应。自第1周期治疗结束患者临床症状明显改善，4周期后kps评分平均提高13.8分。MRI T1WI增强相可见强化区域病灶较治疗前平均缩小54.8%，（P=0.001），MRI T2WI相可见水肿区域较治疗前平均缩小80.7%（P=0.004）。结论 初步证实贝伐单抗能控制脑转移瘤，明显减轻颅内水肿，并改善脑转移瘤的临床症状 关键词：贝伐单抗；脑转移瘤；颅脑水肿；全脑放疗 Abstract：Objective To evaluate the clinical effect of bevacizumab for recurrence or progression brain metastases after whole brain radiotherapy .Methods Retrospective analysis of 20 cases of recurrence or progession brain metastases after radiotherapy， a total of 28 lesions. Patients had primary tumor history and pathology were obtained， the lesions were also satisfy the following the image evidence： CT or MRI enhanced lesions showed foci in the strengthening and accompanied by edema； All patients were given bevacizumab 5mg / kg， every 14 days repeated 1 time for 8 cycles. After the forth cycles of treatment， MRI was examined before and after treatment， and the changes of T1WI phase and edema of T1WI phase were compared before and after treatment. The clinical symptoms， KPS score ， the size of the lesion， edema were record respectively before and after treatment. Comarision before and afer treatment was perofomed by paried t test. Results All the 20 patients receive treatment successfully， and no serious adverse reactions were found. The clinical symptoms of the patients were significantly improved after first cycles of treatment， and the KPS score increased by 13.8 points on average after 4 cycles. The regional lesions of T1WI MRI enhanced phase were smaller average 54.8% than before treatment， （P= 0.001）， T2WI MRI edema region were smaller average 80.7% compared with the before treatment （P= 0.004）.Conclusion Bevacizumab is preliminary confirmed to control the brain