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贝伐珠单抗治疗日本患者神经纤维瘤病 2 型相关前庭神经鞘瘤。

Bevacizumab Therapy of Neurofibromatosis Type 2 Associated Vestibular Schwannoma in Japanese Patients.

机构信息

Department of Neurosurgery, Fukushima Medical University.

出版信息

Neurol Med Chir (Tokyo). 2020 Feb 15;60(2):75-82. doi: 10.2176/nmc.oa.2019-0194. Epub 2020 Jan 3.

Abstract

We conducted a feasibility study to investigate the therapeutic effect of bevacizumab on vestibular schwannomas (VS) associated with neurofibromatosis type 2 (NF2) in a sample of Japanese patients. Ten NF2 patients were selected between 2013 and 2018: nine women and one man, with ages ranging from 12 to 45 years (mean: 29.4). Bevacizumab was administered intravenously in 5 mg/kg doses four times, with an inter-dose interval of 2 weeks. Seventeen tumors were followed for 3-72 months (mean: 39). A reduction from baseline tumor volume of at least 20% was considered a therapeutic radiologic response. Maximum reduction in tumor volume was identified in the 3rd month in 11 tumors, and in the 6th month in three tumors. Three tumors did not show any response to bevacizumab. A radiologic response was detected in seven tumors (41%). There was a significantly lower tumor volume mean in the 3rd month in comparison to the baseline for the entire sample. Tumors in patients aged 25 and above showed a significant reduction in volume in the 3rd month and significantly lower tumor-volume-to-baseline ratio than younger patients in both the 3rd and 6th months. The interaction between 'time' and 'age group' factors significantly affected the therapeutic outcome of bevacizumab on tumor volume. This study investigated the therapeutic effects of bevacizumab on NF2-associated vestibular schwannomas in Japanese patients. Bevacizumab appears to be a useful therapeutic choice in NF2 cases to control the growth of VS. Therefore, a randomised control trial to prove this assumption is necessary.

摘要

我们进行了一项可行性研究,以调查贝伐单抗在日本患者的神经纤维瘤病 2 型(NF2)相关前庭神经鞘瘤(VS)中的治疗效果。2013 年至 2018 年间选择了 10 名 NF2 患者:9 名女性和 1 名男性,年龄在 12 至 45 岁之间(平均:29.4 岁)。贝伐单抗以 5mg/kg 的剂量静脉内给药四次,剂量间隔为 2 周。17 个肿瘤的随访时间为 3-72 个月(平均:39 个月)。基线肿瘤体积减少至少 20%被认为是治疗性影像学反应。11 个肿瘤的最大肿瘤体积减少发生在第 3 个月,3 个肿瘤发生在第 6 个月。3 个肿瘤对贝伐单抗没有任何反应。7 个肿瘤(41%)检测到影像学反应。与整个样本的基线相比,第 3 个月的肿瘤体积平均值明显降低。25 岁及以上患者的肿瘤在第 3 个月体积明显缩小,第 3 个月和第 6 个月的肿瘤体积与基线比值明显低于年轻患者。“时间”和“年龄组”因素之间的相互作用显著影响了贝伐单抗对肿瘤体积的治疗效果。本研究调查了贝伐单抗在日本 NF2 相关前庭神经鞘瘤患者中的治疗效果。贝伐单抗似乎是 NF2 病例中控制 VS 生长的一种有用的治疗选择。因此,有必要进行一项随机对照试验来证明这一假设。

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