SRT联合贝伐珠单抗治疗肺腺癌脑转移瘤的疗效评估

Efficacy and safety of stereotactic radiotherapy combined with bevacizumab for brain metastases of lung adenocarcinoma

目的 研究SRT联合贝伐珠单抗治疗肺腺癌脑转移瘤的有效性及安全性。 方法 回顾分析SRT联合贝伐单抗治疗的肺腺癌脑转移瘤患者 36例,并与同期 59例SRT联合激素和甘露醇治疗的传统药物组患者进行对比,分析两组患者肿瘤缓解率、瘤周水肿控制率、KPS评分改善情况并对相关不良反应进行评估。 结果 贝伐单抗组患者的近期（1~4周）肿瘤缓解率较传统药物组更有优势（P=0.033）,瘤周水肿控制率明显优于传统药物组（P=0.000）,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,药物相关性不良反应较轻且可控。 结论 SRT联合贝伐珠单抗治疗肺腺癌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,改善患者生活质量。

Objective To evaluate the clinical efficacy and safety of stereotactic radiotherapy（SRT） combined with bevacizumab for brain metastases in patients with lung adenocarcinoma. Methods The clinical data of 95 patients with brain metastases of lung adenocarcinoma were retrospectively analyzed, including 36 patients treated with SRT and bevacizumab （bevacizumab group） and 59 patients treated with SRT, corticosteroids, and mannitol （traditional drug group）. The tumor response rate, peritumoral edema control rate, improvement in Karnofsky Performance Scale （KPS） score, and adverse reactions were analyzed. Results Compared with the traditional drug group, the bevacizumab group had significantly higher tumor response rate （P=0.033） and peritumoral edema control rate （P=0.000） at 1-4 weeks after treatment, as well as an obvious improvement in KPS score and reduced doses of corticosteroids and mannitol. In addition, the adverse reactions in the bevacizumab group were mild and controllable. Conclusions SRT combined with bevacizumab for brain metastases in patients with lung adenocarcinoma can achieve higher short-term tumor response rate and peritumoral edema control rate and improve patients’ quality of life.