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立体定向放射治疗联合贝伐珠单抗治疗脑转移瘤的临床研究

发表者:李勇 人已读


潘绵顺 李勇   邱书珺   郭裕天  邵显军   张丽   张国禹   诸葛风华第二军医大学附属东方肝胆外科医院放疗科李勇

[摘要]  目的  研究立体定向放射治疗(SRT)联合贝伐珠单抗治疗脑转移瘤的有效性及安全性。 方法  回顾性总结SRT联合贝伐珠单抗治疗的脑转移瘤患者49例(肺癌脑转移瘤患者38例,乳腺癌脑转移瘤患者5例,肠癌脑转移瘤患者6例),并与同期78例(肺腺癌脑转移瘤患者60例,乳腺癌脑转移瘤患者12例,肠癌脑转移瘤患者6例)SRT联合激素和甘露醇治疗的传统药物组患者进行对比,分析两组患者的肿瘤缓解率、瘤周水肿的控制率、KPS评分的改善情况并对相关副作用进行评估。 结果  贝伐珠单抗组患者的近期(1-4周)肿瘤缓解率较传统药物组更有优势X2=6.537, P=0.037;近期瘤周水肿控制率明显优于传统药物组(t=3.256, P<0.001),在快速获得的KPS评分提升的同时减少了甘露醇和激素的应用,药物相关性副作用较轻且可控。 结论 SRT联合贝伐珠单抗治疗脑转移瘤能获得更高的近期肿瘤缓解率和瘤周水肿控制率,可能是治疗脑转移瘤的理想组合。

[关键词]  立体定向放射治疗;贝伐珠单抗;脑转移瘤

Stereotactic radiotherapy with bevacizumab for brain metastases  Pan Mianshun*, Li Yong, Qiu Shujun, GuoY-tian, Shao Xianjun, Zhang Li, Zhang Guoyu, Zhuge Fenghua. *Shanghai center of Radiation Oncology, Chinese People’s armed police Forces, Shanghai, 201103, China

[Abstract] Objective To evaluate the clinical efficacy of stereotactic radiotherapy with bevacizumab for brain metastases. Method Retrospective analysis of 49 patients with brain metastases which have ever been treated by stereotactic radiotherapy with bevacizumab, and compare with the same period 78 patients which have ever been treated by stereotactic radiotherapy with corticosteroids and mannitol. The response rate of the tumor, the control rate of the peritumoral edema, the improvement of the KPS score and the side-effect were analyzed at last. Result Compared with the patients of the traditional drugs group, the patients of the bevacizumab group have better tumor response rate (X2=6.537, P=0.037) and peritumoral edema control rate (t=3.256, P<0.001) after 1-4 weeks of SRT, they achieved obvious KPS improvement with dosage reduction of corticosteroids. The side-effect of bevacizumab is mild and controllable. Conclusion The better tumor response rate, peritumoral edema control rate and quality of life can be achieved when the brain metastases were treated by stereotactic radiotherapy with bevacizumab.


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发表于:2017-12-21 22:32

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