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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且伴有明显水肿影；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检査，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
2、分改变情况，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。MRTT1WI增强相可见强化区域病灶较治疗前平均缩小54.8%,(P=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:Obje
3、ctiveToevaluatetheclinicaleffectofbevacizumabforrecurrenceorprogressionbrainmetastasesafterwholebrainradiotherapy.MethodsRetrospectiveanalysisof20casesofrecurreneeorprogessionbrainmetastasesafterradiotherapy,atotalof28lesions.Patientshadprimarytumorhis
4、toryandpathologywereobtained,thelesionswerealsosatisfythefollowingtheimageevidence：CTorMRIenhancedlesionsshowedfociinthestrengtheningandaccompaniedbyedema；Al1patientsweregivenbevacizumab5mg/kg,every14daysrepeated1timefor8cycles.Aftertheforthcyclesoftre
5、atment,MRIwasexaminedbeforeandaftertreatment,andthechangesofT1WTphaseandedemaofT1WIphasewerecomparedbeforeandaftertreatment・Theclinicalsymptoms,KPSscore，thesizeofthelesion,edemawererecordrespectivelybeforeandaftertreatment・Comarisionbeforeandafertreatm
6、entwasperofomedbypariedttest.ResultsAllthe20patienlsreceivetreatmentsuccessfully,andnoseriousadversereactionswerefound・Theclinicalsymptomsofthepatientsweresignificantlyimprovedafterfirstcyclesoftreatment,andtheKPSscoreincreasedby13.8pointsonaverageafte
7、r4cycles・TheregionallesionsofT1W1MRIenhancedphaseweresmalleraverage54.8%thanbeforetreatment,(P=0.001),T2WIMRIedemaregionweresmalleraverage80.7%comparedwiththebeforetreatment(P=0.004).ConclusionBevacizumabispreliminaryconfirmedtocontrolthebrainmetastati
8、ctumor,alleviatecerebraledema,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
