贝伐单抗治疗放射性脑坏死的疗效分析

The efficacy of bevacizumab on the treatment of cerebral radiation necrosis

目的评估贝伐单抗治疗放射性脑坏死的疗效。方法收集本院2011年6月至2013年2月期间行射波刀立体定向放疗后，影像学诊断为放射性脑坏死患者14例。应用贝伐单抗治疗，剂量5mg／kg，每3周1次，至少连用3次。以治疗前后脑坏死症状变化、颅内水肿体积、脑坏死体积、脑坏死MRI信号变化为第1观察点。以贝伐单抗治疗的不良反应为第2观察点。结果治疗后贝伐单抗治疗脑坏死病灶前后水肿指数、脑坏死体积、核磁信号比分别为7．05±6．48、（55．96±32．91）ml、2．70±4．78和3．59±4．74、（26．99±31．40）ml、1．82±0．53，结果差异均有统计学意义（t=3．946、3．952、4．507，P〈0．01）。贝伐单抗不良反应较轻，未见2级以上不良反应。结论贝伐单抗治疗放射性脑坏死安全、有效，值得进一步研究。

Objective To evaluate the efficacy of bevacizumab on the treatment of cerebral radiation necrosis. Methods 14 cases were collected from June 2011 to February 2013 in Tianjin Medical Cancer Hospital, who were diagnosed as cerebral radiation necrosis. Patients were treated with bevacizumab a dose of 5 mg/kg, once every 3 weeks, at least 3 times. The changes of symptoms of brain necrosis, the volume of intracranial edema, the volume of brain necrosis, and the MRI signal changes were used as the first observation points. The adverse reactions of bevaeizumab were used as the second observation points. Results The edema index, brain necrosis volume, MRI signal ratio before and after bevacizumab treatment brain necrosis lesions were 7.05 ±6.48, （55.96 ±32. 91 ） ml, 2. 70 ±4. 78 and 3.59 ±4.74, （26. 99 ±31.40） ml, 1.82 ±0. 53, respectively, with statistical significant differences between the two groups （t = 3. 946, 3. 952, 4. 507, P 〈 0.01 ）. The adverse reaction of bevacizumab was less, and there were no more than 2 degree adverse reactions. Conclusions Bevacizumab is effective and safe in the treatment of cerebral radiation necrosis, worthy of further study.