贝伐珠单抗治疗放射性脑水肿临床疗效观察

Clinical Efficacy Observation of Bevacizumab in the Treatment of Radiation-Induced Cerebral Edema

摘要: 目的：评估贝伐珠单抗在治疗放射性脑水肿中的疗效及安全性。方法：将46例放射性脑水肿患者随机分为试验组与对照组，试验组于放疗前5天使用贝伐珠单抗5 mg/Kg，每2周应用一次至放疗后1个月，患者出现高颅压症状(头痛、恶心、呕吐、肢体活动障碍等)时应用甘露醇和地塞米松。对照组仅在患者出现高颅压症状时应用甘露醇和地塞米松。所有患者均于放疗前、放疗后1月行颅脑增强MRI检查。比较两组脑水肿的改善情况及患者ECOG评分改善情况、安全性。结果：贝伐珠单抗联合常规治疗较单纯常规治疗对改善脑水肿的有效率明显提高(P < 0.05)，差别有统计学意义，生活质量明显改善(P < 0.05)，差别有统计学意义，试验组未出现3级以上毒副作用。结论：应用贝伐珠单抗可减轻放射性脑水肿，提高患者生活质量，安全性可耐受。

Abstract: Objective: To assess the efficacy and safety of bevacizumab in the treatment of radiation cerebral oedema. Methods: Forty-six patients with radiation cerebral edema were randomly divided into experimental group and control group, and the experimental group was given bevacizumab 5mg/kg 5 days before radiotherapy, applied once every 2 weeks to 1 month after radiotherapy, and mannitol and dexamethasone were applied when the patients had symptoms of high intracranial pressure (headache, nausea, vomiting, limb movement disorders, etc.). The control group should only use mannitol and dexamethasone when the patient has symptoms of high intracranial pres-sure. All patients underwent MRI with contrast to the brain before and 1 month after radiotherapy. The improvement of cerebral edema and the improvement of ECOG score and safety of the two groups were compared. Results: The effectiveness of bevacizumab combined with conventional treatment in improving cerebral edema was significantly higher than that of conventional treat-ment alone (P < 0.05), the difference was statistically significant, and the quality of life was signifi-cantly improved (P < 0.05), the difference was statistically significant, and there were no toxic side effects above grade 3 in the experimental group. Conclusion: The application of bevacizumab can reduce radiation cerebral edema, improve the quality of life of patients, and be tolerated safely.