Sfakianos Gregory P, Numnum T Michael, Halverson Caitlin B, Panjeti Deepa, Kendrick James E, Straughn J Michael
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, University of Alabama at Birmingham, Birmingham, Alabama 35249-7333, USA.
Gynecol Oncol. 2009 Sep;114(3):424-6. doi: 10.1016/j.ygyno.2009.05.031. Epub 2009 Jun 23.
To determine the rate of gastrointestinal perforation and/or fistula in patients with recurrent ovarian cancer treated with and without bevacizumab.
A retrospective chart review from January 2004 to August 2007 identified two cohorts of patients with recurrent ovarian cancer: 1) patients who were receiving bevacizumab either alone or in combination with standard chemotherapy; 2) patients who were receiving standard chemotherapy alone. Gastrointestinal toxicity (perforation and fistula) was assessed using NCI Common Toxicity Criteria. Relative risk and 95% confidence intervals were calculated. Chi square test and student's t test were used for statistical analysis.
Sixty-eight patients receiving bevacizumab for recurrent ovarian cancer were identified. 67% of these patients received chemotherapy in combination with bevacizumab. For comparison, 195 patients receiving standard chemotherapy alone for recurrent ovarian cancer were identified. A history of previous gastrointestinal resection (40% vs. 37%; p=0.79) and gastrointestinal obstruction (30% vs. 27%; p=0.74) was similar in both cohorts. Five patients (7.2%) developed a gastrointestinal perforation and/or fistula in the bevacizumab cohort compared to 13 patients (6.5%) in the chemotherapy alone cohort. The relative risk for developing a perforation and/or fistula is 1.09 (95% CI, 0.40 to 2.96).
Although a substantial number of patients with recurrent ovarian cancer experience gastrointestinal obstruction, the rate of gastrointestinal perforation and/or fistula is relatively low. Treatment with bevacizumab does not significantly increase gastrointestinal toxicity compared to standard salvage chemotherapy.
确定接受和未接受贝伐单抗治疗的复发性卵巢癌患者发生胃肠道穿孔和/或瘘管的发生率。
对2004年1月至2007年8月的病历进行回顾性分析，确定了两组复发性卵巢癌患者：1）单独接受贝伐单抗或与标准化疗联合使用的患者；2）仅接受标准化疗的患者。使用美国国立癌症研究所通用毒性标准评估胃肠道毒性（穿孔和瘘管）。计算相对风险和95%置信区间。采用卡方检验和学生t检验进行统计分析。
确定了68例接受贝伐单抗治疗复发性卵巢癌的患者。其中67%的患者接受了贝伐单抗联合化疗。作为对照，确定了195例仅接受标准化疗治疗复发性卵巢癌的患者。两组患者既往胃肠道切除术史（40%对37%；p = 0.79）和胃肠道梗阻史（30%对27%；p = 0.74）相似。贝伐单抗组有5例患者（7.2%）发生了胃肠道穿孔和/或瘘管，而单纯化疗组有13例患者（6.5%）发生。发生穿孔和/或瘘管的相对风险为1.09（95%CI，0.40至2.96）。
尽管大量复发性卵巢癌患者经历胃肠道梗阻，但胃肠道穿孔和/或瘘管的发生率相对较低。与标准挽救化疗相比，使用贝伐单抗治疗不会显著增加胃肠道毒性。
