贝伐珠单抗联合白介素-2腹腔灌注治疗恶性腹腔积液的有效性及安全性

The efficacy and safety of bevacizumab combined with interleukin-2 intraperitoneal perfusion in the treatment of malignant ascites

目的探讨贝伐珠单抗联合白介素-2腹腔灌注治疗恶性腹腔积液的有效性和安全性。方法选取2019年1月至2020年6月我院治疗的90例晚期恶性肿瘤并发腹腔积液患者,采用随机数字法分为三组各30例。A组采用贝伐珠单抗联合白介素-2腹腔灌注,B组采用贝伐珠单抗腹腔灌注,C组采用白介素-2腹腔灌注;比较三组患者近期临床疗效、KPS评分、细胞免疫功能、血管内皮生长因子及不良反应情况。结果A组近期临床疗效、KPS评分改善均优于B、C组,差异有统计学意义(P<0.05);三组患者治疗前后免疫指标细胞活性比较,差异无统计学意义(P>0.05);治疗后血清血管内皮生长因子A组低于B组和C组,差异有统计学意义(P<0.05);三组均未发生高血压、蛋白尿和出血,均未发生3级以上不良反应。结论贝伐珠单抗联合白介素-2腹腔灌注治疗恶性腹腔积液总体疗效优于单独使用贝伐珠单抗或白介素-2腹腔灌注治疗,未增加化疗药物的不良反应,具有一定的临床推广价值。

Objective To explore the effectiveness and safety of bevacizumab combined with interleukin-2(IL-2)intraperitoneal perfusion in the treatment of malignant ascites.Methods From January 2019 to June 2020,90 patients with advanced malignant tumors complicated with ascites were selected and randomly divided into A,B and C groups with 30 cases in each group.The group A was treated with bevacizumab combined with IL-2 intraperitoneal infusion.In the group B,bevacizumab was used for intraperitoneal infusion and in the group C IL-2 was used for intraperitoneal infusion.The short-term clinical efficacy,KPS score,cellular immune function,and vascular endothelial growth factor(VEGF)were recorded in the 3 groups,and the adverse reactions of the 3 groups were observed.Results The short-term clinical efficacy,KPS score and quality of life improvement in the group A were better than those in the groups B and C(P<0.05).There was no significant decrease in immune cell activity of the three groups before and after treatment(P>0.05).After treatment,serum VEGF in the group A was lower than that in the group B and C(P<0.05).There were no adverse reactions such as hypertension,proteinuria and bleeding in the three groups and no adverse reactions above grade 3 occurred.Conclusion The overall curative effect of bevacizumab combined with IL-2 intraperitoneal infusion in the treatment of malignant ascites is better than that of bevacizumab or IL-2 alone and it does not increase the adverse reactions of chemotherapy drugs.It has certain clinical promotion value.