Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77230, USA.
Lancet Oncol. 2010 Apr;11(4):373-82. doi: 10.1016/S1470-2045(09)70341-9. Epub 2010 Feb 18.
Vascular endothelial growth factor (VEGF) targeted therapy, either alone or in combination with chemotherapy, has become the standard of care in several solid tumours, including colorectal cancer, renal-cell carcinoma, breast cancer, non-small-cell lung cancer, and glioblastoma. VEGF is crucial in the process of angiogenesis and wound healing and, thus, its inhibition has the potential to affect wound healing in patients undergoing surgery. In this review, we summarise the data available on the use of VEGF-targeted therapies, and their effect on perioperative wound complications. Surgery in patients receiving VEGF-targeted therapies seems to be safe when an appropriate interval of time is allowed between surgical procedures and treatment. Recommendations regarding this interval are provided in a disease and agent site-specific manner. We also discuss complications arising from the use of VEGF-directed therapies that might require surgical intervention and the considerations important in their management. At this juncture, safety data on the use of VEGF-targeted therapies in the perioperative period are sparse, and investigators are urged to continue to study this issue prospectively in current and future clinical trials to establish firm guidelines.
血管内皮生长因子 (VEGF) 靶向治疗，无论是单独使用还是与化疗联合使用，已成为包括结直肠癌、肾细胞癌、乳腺癌、非小细胞肺癌和胶质母细胞瘤在内的几种实体瘤的标准治疗方法。VEGF 在血管生成和伤口愈合过程中至关重要，因此其抑制作用有可能影响接受手术的患者的伤口愈合。在这篇综述中，我们总结了关于使用 VEGF 靶向治疗及其对围手术期伤口并发症影响的可用数据。当在手术和治疗之间留出适当的时间间隔时，接受 VEGF 靶向治疗的患者的手术似乎是安全的。针对这种间隔时间，以疾病和药物特定的方式提供了建议。我们还讨论了可能需要手术干预的使用 VEGF 定向疗法引起的并发症，以及在管理这些并发症时需要考虑的重要因素。在这一时刻，关于围手术期使用 VEGF 靶向治疗的安全性数据还很缺乏，因此敦促研究人员继续在当前和未来的临床试验中前瞻性地研究这个问题，以制定明确的指南。
