Lordick Florian, Geinitz Hans, Theisen Joerg, Sendler Andreas, Sarbia Mario
Third Department of Internal Medicine (Hematology/Medical Oncology), Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Int J Radiat Oncol Biol Phys. 2006 Apr 1;64(5):1295-8. doi: 10.1016/j.ijrobp.2005.12.004. Epub 2006 Feb 28.
To assess the rate of severe bowel complications during treatment with the anti-vascular endothelial growth factor monoclonal antibody bevacizumab.
We performed a retrospective evaluation of bevacizumab-associated severe intestinal adverse events from our institutional database.
A total of 33 patients started treatment with bevacizumab at our institution during the first 6 months after its approval in Germany. Three patients (9%) presented with severe bowel complications: two with acute ischemic colitis and one with gastrointestinal perforation with a fatal outcome. All 3 patients had undergone radiotherapy directed to the pelvis before treatment with bevacizumab. None of the 30 patients without bowel complications had been pretreated with infradiaphragmatic irradiation. Histologic evaluation of bowel biopsies and resection specimens revealed severe ischemic bowel damage as the pathophysiologic background of the clinical findings.
This report contributes to the pathophysiologic clarification of bevacizumab-induced bowel complications and points to a potentially increased risk of severe ischemic damage during treatment with bevacizumab in patients who have undergone previous radiotherapy.
评估抗血管内皮生长因子单克隆抗体贝伐单抗治疗期间严重肠道并发症的发生率。
我们从机构数据库中对与贝伐单抗相关的严重肠道不良事件进行了回顾性评估。
在德国批准后的前6个月内，共有33例患者在我们机构开始使用贝伐单抗治疗。3例患者（9%）出现严重肠道并发症：2例为急性缺血性结肠炎，1例为胃肠道穿孔并导致死亡。所有3例患者在使用贝伐单抗治疗前均接受过盆腔放疗。30例无肠道并发症的患者均未接受过膈下照射预处理。对肠道活检和切除标本的组织学评估显示，严重缺血性肠损伤是临床发现的病理生理背景。
本报告有助于对贝伐单抗所致肠道并发症进行病理生理阐释，并指出既往接受过放疗的患者在使用贝伐单抗治疗期间发生严重缺血性损伤的风险可能增加。
