贝伐珠单抗相关的胃肠道穿孔在既往接受三种或以上化疗方案的患者中：真实世界经验。

Bevacizumab-related gastrointestinal perforation in patients with three or more prior chemotherapy regimens: A real-world experience.

机构信息

Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo 003-0804, Japan.

出版信息

Taiwan J Obstet Gynecol. 2020 May;59(3):377-380. doi: 10.1016/j.tjog.2020.03.007.

DOI:10.1016/j.tjog.2020.03.007

PMID:32416883

Abstract

OBJECTIVE

Associations between the number of prior chemotherapy (CT) regimens and gastrointestinal (GI) perforation in patients receiving bevacizumab treatment has not been fully investigated. The aim of the study was to investigate the impact of ≥3 prior CT regimens on GI perforation.

MATERIALS AND METHODS

We retrospectively investigated the medical records of 133 patients with gynecological cancer who received bevacizumab-containing treatment. Bevacizumab was intravenously administered at a dose of 15 mg/kg every 4 weeks. Incidence of GI perforation was compared between ≤2 and ≥3 prior CT groups.

RESULTS

Twenty-three (17.3%) patients had a history of ≥3 CT; these patients received bevacizumab at 4-week intervals. The percentage of patients with prior surgery was significantly higher in the ≥3 prior CT group (95.7% vs. 70.0%, P = 0.008), while those with prior bowel resection was significantly higher in the ≥3 prior CT group (30.4% vs. 12.7%, P = 0.034). There was no significant difference in the mean number of bevacizumab cycles between the two groups (10.7 vs. 8.9, P = 0.19). While GI perforation was observed in three (2.7%) patients in the ≤2 prior CT group, no GI perforation was found in the ≥3 prior CT group (P > 0.99).

CONCLUSION

A history of ≥3 prior CT did not increase the risk for GI perforation when bevacizumab is administered at a dose of 15 mg/kg every 4 weeks in our cases.

摘要

目的

接受贝伐珠单抗治疗的患者中，先前化疗（CT）方案数量与胃肠道（GI）穿孔之间的关系尚未得到充分研究。本研究旨在探讨≥3 个先前 CT 方案对 GI 穿孔的影响。

材料和方法

我们回顾性调查了 133 例接受贝伐珠单抗治疗的妇科癌症患者的病历。贝伐珠单抗的剂量为 15mg/kg，每 4 周静脉给药一次。比较了≤2 个和≥3 个先前 CT 组之间 GI 穿孔的发生率。

结果

23 例（17.3%）患者有≥3 次 CT 史；这些患者以 4 周的间隔接受贝伐珠单抗治疗。≥3 个先前 CT 组的既往手术患者比例明显较高（95.7%比 70.0%，P=0.008），而≥3 个先前 CT 组的既往肠切除术患者比例明显较高（30.4%比 12.7%，P=0.034）。两组之间贝伐珠单抗周期的平均数量无显著差异（10.7 比 8.9，P=0.19）。在≤2 个先前 CT 组中，有 3 例（2.7%）患者出现 GI 穿孔，而在≥3 个先前 CT 组中则未发现 GI 穿孔（P>0.99）。