CAJ | 학술논문

目的了解贝伐株单抗(BEV)治疗国人复发恶性胶质瘤(HGG)的临床疗效,评估其不良反应发生率和使用安全性.方法选取2010年1月至2013年12月在南方医科大学南方医院行BEV(10 mg/kg,每2周)联合替莫唑胺(TMZ,150 mg/m2,5 d/28 d)治疗的15例复发HGG患者,其中胶质母细胞瘤(GBM)12例,间变性星形细胞瘤(AA)3例,判断其影像学和临床获益,行无进展生存(PFS)及总体生存分析,评估不良反应出现情况及严重程度.结果使用后出现高血压2例,切口愈合不良并发颅内感染1例,恶心呕吐2例,脑脊液漏1例,经积极治疗以上不良反应均治愈.按照RANO标准,15例中,短期(＜3个月)明显影像学和临床获利的11例(73.3％),使用6个月后仍无肿瘤进展8例(53.3％),平均PFS时间(8±5)个月.长期随访(＞6个月),8例肿瘤再进展,其中5例死亡,总体生存时间(24±10)个月.结论对比西方人种,BEV化疗对国人复发HGG有更好的短期临床和影像学效果,但长期疗效无明显差异.严重不良反应发生率较西方人种低,临床耐受性良好.对再次手术患者,应推迟至术后1个月左右使用,以减少切口愈合相关并发症.
목적 료해패벌주단항(BEV)치료국인복발악성효질류(HGG)적림상료효,평고기불량반응발생솔화사용안전성.방법 선취2010년1월지2013년12월재남방의과대학남방의원행BEV(10 mg/kg,매2주)연합체막서알(TMZ,150 mg/m2,5 d/28 d)치료적15례복발HGG환자,기중효질모세포류(GBM)12례,간변성성형세포류(AA)3례,판단기영상학화림상획익,행무진전생존(PFS)급총체생존분석,평고불량반응출현정황급엄중정도.결과 사용후출현고혈압2례,절구유합불량병발로내감염1례,악심구토2례,뇌척액루1례,경적겁치료이상불량반응균치유.안조RANO표준,15례중,단기(＜3개월)명현영상학화림상획리적11례(73.3％),사용6개월후잉무종류진전8례(53.3％),평균PFS시간(8±5)개월.장기수방(＞6개월),8례종류재진전,기중5례사망,총체생존시간(24±10)개월.결론 대비서방인충,BEV화료대국인복발HGG유경호적단기림상화영상학효과,단장기료효무명현차이.엄중불량반응발생솔교서방인충저,림상내수성량호.대재차수술환자,응추지지술후1개월좌우사용,이감소절구유합상관병발증.
Objective To explore the clinical efficacies of bevacizumab (BEV) for high-grade glioma (HGG) in Chinese patients and evaluate its profiles of adverse events and usage safety.Methods A total of 15 HGG cases,including glioblastoma multiform (GBM) (n =12) and anaplastic astrocytoma (AA) (n =3),were selected to receive the treatments of BEV (10 mg/kg,q2w) and temozolomid (TMZ,150 mg/m2,5 d/28 d).Their radiological responses,clinical status,progression-free survival (PFS) and overall survival (OS) were evaluated.Also their adverse events and severity were recorded and analyzed.Results According to the RANO criteria,during the short period (＜ 3 months),11 cases had significant radiological and clinical responses.However,only 4 cases responded during a follow-up period of beyond 3 months.Three cases had reprogression after BEV chemotherapy.At 6 months post-treatment,8 cases (53.3％) survived without lesion progression and the median PFS was 8 ± 5 months.During a longer follow-up (＞ 6 months),8 patients had tumor reprogression,including 5 deaths.The median overall survival period was 24 ± 10 months.The adverse events included hypertension (n =2),wound-healing complication (n =1),vomiting (n =2) and cerebro-spinal fluid leakage (n =1).All complications were cured by activate supportive measures.Conclusion After BEV treatment,most patients obtain more significant short-term responses with good toleration.For re-operative cases,the usage of BEV should be deferred to one month post-operation so as to avoid the occurrence of wound-healing complications.