小剂量贝伐珠单抗治疗局限性放射性脑坏死的疗效及安全性研究

doi:10.19854/j.cnki.1008-2425.2025.06.0004

摘要/Abstract

摘要： 目的评价小剂量贝伐珠单抗治疗局限性放射性脑坏死的临床疗效及安全性。方法回顾性分析2021年1月至2025年1月经病理或影像学确诊的局限性放射性脑坏死患者20例。所有患者给予小剂量贝伐珠单抗(3 mg/kg,每3周1次,共4周期)治疗。通过核磁共振检查评价第二周期治疗前影像学缓解率及治疗结束后3个月的影像学缓解率;同时记录患者临床症状改善率、KPS评分变化、无进展生存期(PFS)及不良事件。伦理批号:NO.KY(2023001)结果共纳入20例患者,每例患者均完成4周期治疗,治疗后全组患者水肿指数显著降低(4.66±5.68 vs 8.64±4.83);病灶体积较治疗前明显降低;第二周期治疗前影像学缓解率为70%(14/20),治疗结束后3个月影像学缓解率为85%(17/20),临床症状改善率为90%(18/20),治疗后KPS评分由55.60±16.18提高至76.64±18.96。中位随访时间为12个月,中位PFS为10个月。不良事件为高血压5例、蛋白尿3例、鼻出血3例、牙龈出血2例,均为1~2级,未发生严重不良事件。结论小剂量贝伐珠单抗治疗局限性放射性脑坏死具有良好的疗效和安全性,可作为局限性放射性脑坏死的一种治疗选择。

关键词: 贝伐珠单抗, 放射性脑坏死, 疗效, 安全性

Abstract: Objective To assess the clinical efficacy and safety of low-dose bevacizumab in the treatment of localized radiation brain necrosis. Methods A retrospective analysis was performed for 20 patients with pathologic or radiographically confirmed localized radiation brain necrosis from January 2021 to January 2025.All patients were treated with low-dose bevacizumab(3 mg/kg,onceevery 3 weeks for 4 cycles).The radiographic remission rate before the second cycle of treatment and the radiographic remission rate at 3 months after the end of treatment were evaluated by MRI.At the same time,the improvement rate of clinical symptoms,changes in KPS score,progression-free survival(PFS) and adverse events were recorded. Results A total of 20 patients were included,and each patient completed 4 cycles of treatment,and the edema index of all patients in the whole group was significantly reduced after treatment(4.66±5.68 vs 8.64±4.83).The volume of lesions was significantly lower than before treatment;The imaging remission rate was 70%(14/20) before the second cycle of treatment,85%(17/20) and 90%(18/20) after the end of treatment,and the KPS score increased from 55.60±16.18 to 76.64±18.96 after treatment.The median follow-up was 12 months and the median PFS was 10 months.The adverse events were hypertension in 5 cases,proteinuria in 3 cases,epistaxis in 3 cases,and gingival bleeding in 2 cases,all of which were grade 1-2,and no serious adverse events occurred. Conclusion Low-dose bevacizumab for the treatment of localized radiation brain necrosis has good efficacy and safety,and can be used as a treatment option for localized radiation brain necrosis.

Key words: Bevacizumab, Radiation brain necrosis, Efficacy, Security

中图分类号:

R741

王镇, 何占彪. 小剂量贝伐珠单抗治疗局限性放射性脑坏死的疗效及安全性研究[J]. 立体定向和功能性神经外科杂志, 2025, 38(6): 339-343.

Wang Zhen, He Zhanbiao. Efficacy and safety of low-dose bevacizumab in the treatment of localized radiation brain necrosis[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2025, 38(6): 339-343.

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