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1、贝伐单抗维持治疗脑转移瘤疗效与安全性分析摘要：目的评估贝伐单抗治疗全脑放疗后复发或进展脑转移瘤的临床疗效。方法回顾分析放疗后进展或复发脑转移瘤患者21例，共计28处病灶。患者有原发肿瘤病史且均取得病理，病灶均同时满足以下各项影像学证据：CT或MRI增强病灶表现为灶内强化但伴有明显水肿影；所有患者均给予贝伐单抗5mg/kg,每14d重复1次，治疗4〜8个周期。每4周期治疗后第5周期治疗前均行MRI检查，比较治疗前后T1WI相增强病灶大小变化及T1WI相病灶水肿变化。记录患者治疗前、后临床症状、kps评分改变情
2、况，治疗前、后病灶大小、水肿变化以及KPS评分行t检验。结果21例患者均安全完成治疗，未见明显严重不良反应。自第1周期治疗结束患者临床症状明显改善，4周期后kps评分平均提高13.8分。MRIT1WI增强相可见强化区域病灶较治疗前平均缩小54.8%,（P二0.001）,MRIT2WI相可见水肿区域较治疗前平均缩小80.7%（P二0.004）。结论初步证实贝伐单抗能控制脑转移瘤，明显减轻颅内水肿，并改善脑转移瘤的临床症状。关键词：贝伐单抗；脑转移瘤；颅脑水肿；全脑放疗Abstract:ObjectiveToe
3、valuatetheclinicaleffectofbevacizumabforrecurrenceorprogressionbrainmetastasesafterwholebrainradiotherapy.MethodsRetrospectiveanalysisof20casesofrecurrenceorprogessionbrainmetastasesafterradiotherapy,atotalof28lesions.Patientshadprimarytumorhistoryandpatho
4、logywereobtained,thelesionswerealsosatisfythefollowingtheimageevidence：CTorMRIenhancedlesionsshowedfociinthestrengtheningandaccompaniedbyedema；Allpatientsweregivenbevacizumab5mg/kg,every14daysrepeated1timefor8cycles.Aftertheforthcyclesoftreatment,MRIwasexa
5、mincdbeforeandaftertreatment,andthechangesofT1WIphaseandedemaofT1WIphasewerecomparedbeforeandaftertreatment・Theclinicalsymptoms,KPSscore,thesizeofthelesion,edemawererecordrespectivelybeforeandaftertreatment・Comarisionbeforeandafertreatmcntwaspcrofomedbypar
6、iedttost・ResultsAllthe20patientsreceivetreatmentsuccessfully,andnoseriousadversereactionswerefound・Theclinicalsymptomsofthepatientsweresignificantlyimprovedafterfirstcyclesoftreatment,andtheKPSscoreincreasedby13.8pointsonaverageafter4cycles・Theregionallesi
7、onsofT1WIMRIonhancodphaseweresmalleraverage54.8%thanbeforetreatment,(P二0.001),T2WIMRIedemaregionweresmalleraverage80.7%comparedwiththebeforetreatment(P=0.004)•ConelusionBevacizumabispreliminaryconfirmedtocontrolthebrainmetastatictumor,alleviatecerebraledem
8、a,andimproveclinicalsymptomsofbrainmetastases.Keywords:Bevacizumab；Brainmetastases；Encephaledema；Wholebrainradiotherapy恶性肿瘤脑转移是肿瘤常见的并发症，约20%〜40%的癌症患者发生脑转移，尤其是好发生于肺癌和乳腺癌患者［1］。发生脑转移患者预后极差,自然生存时间1〜3个月，全脑放疗(whole
