bevacizumab related hypertension and reversible posterior leukoencephalopathy syndrome in gynecologic malignancies a case control study贝伐单抗相关高血压和可逆的后部脑白质病综合症在妇科恶性肿瘤病例对照研究.pdfVIP

Journal of Cancer Therapy, 2011, 2, 217-223 217 doi:10.4236/jct.2011.22028 Published Online June 2011 (http://www.SciRP.org/journal/jct) Bevacizumab Related Hypertension and Reversible Posterior Leukoencephalopathy Syndrome in Gynecologic Malignancies: A Case Control Study * Sarah N. Cross , Elena S. Ratner, Dan A. Silasi, Alessandro D. Santin, Masoud Azodi, Thomas J. Rutherford, Peter E. Schwartz Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, USA. Email: sarah.cross@ th st th Received March 20 , 2011; revised April 21 , 2011; accepted April 30 , 2011. ABSTRACT Background : Bevacizumab is increasingly being used in the treatment of gynecologic malignancies , but has significant side-effects including hypertension and reversible posterior leukoencephalopathy (RPLS), which must be recognized by the gynecologic oncologist. Methods : A 26-month institutional retrospective review of bevacizumab in the treatment of gynecologic malignancies. Patients were grouped according to whether they had bevacizumab-related hypertension (defined as at least a grade one hypertensive toxicity) or not. There were no differences in patient demographics be- tween the groups. Risk factors for developing bevacizumab-related hypertension were assessed using t-tests, Wilcoxon rank sum test and Fisher’s exact test. Results : Our group has treated 45 patients with bevacizumab. Fifteen (33%) pa- tients had a pre-existing diagnosis of hypertension, 12 (80%) of whom had at least one elevated blood pressure during treatment. The 30 (67%) patients who did not have a pre-existing diagnosis of hypertension still had a high incidence of bevacizumab-related elevated blood pressure (14, 47%). The majority of pa