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急诊科与贝伐单抗治疗及复发性卵巢癌相关的肠穿孔

Bowel Perforation in the Emergency Department Related to Bevacizumab Therapy and Recurrent Ovarian Cancer.

作者信息

Ostby Stuart A, Olushoga Michael, Leath Charles A, Burleson Samuel L

机构信息

University of Alabama at Birmingham, Department of Obstetrics and Gynecology, Birmingham, Alabama.

University of Alabama at Birmingham, Department of Emergency Medicine, Birmingham, Alabama.

出版信息

Clin Pract Cases Emerg Med. 2020 Mar 27;4(2):227-229. doi: 10.5811/cpcem.2020.1.45374. eCollection 2020 May.

DOI:10.5811/cpcem.2020.1.45374
PMID:32426679
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7219984/
Abstract

CASE PRESENTATION

We describe the presentation to the emergency department of a patient with recurrent ovarian cancer treated with bevacizumab with the complication of bowel perforation.

DISCUSSION

We review the frequency and outcomes of bevacizumab-related bowel perforation. We also report the patient's imaging findings, including the radiologic presentation of free intraperitoneal air and portal venous gas, both indicative of bowel perforation and the need for emergent surgical evaluation. Our case also illustrates the potentially catastrophic side effects of bevacizumab and other targeted oncologic therapies of which emergecny physicians may not be aware.

摘要

病例报告

我们描述了一名复发性卵巢癌患者在接受贝伐单抗治疗后出现肠穿孔并发症并前往急诊科就诊的情况。

讨论

我们回顾了贝伐单抗相关肠穿孔的发生率和结局。我们还报告了患者的影像学检查结果，包括腹腔内游离气体和门静脉气体的影像学表现，这两者均提示肠穿孔且需要紧急进行外科评估。我们的病例还说明了贝伐单抗和其他靶向肿瘤治疗可能产生的灾难性副作用，而急诊科医生可能并不知晓这些副作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08de/7219984/8e5665f9ae0c/cpcem-04-227-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08de/7219984/d4c7caf4304c/cpcem-04-227-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08de/7219984/d3e48b669ef6/cpcem-04-227-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08de/7219984/8e5665f9ae0c/cpcem-04-227-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08de/7219984/d4c7caf4304c/cpcem-04-227-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08de/7219984/d3e48b669ef6/cpcem-04-227-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08de/7219984/8e5665f9ae0c/cpcem-04-227-g003.jpg

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本文引用的文献

1
Bevacizumab with or after chemotherapy for platinum-resistant recurrent ovarian cancer: exploratory analyses of the AURELIA trial.贝伐珠单抗联合或不联合化疗治疗铂耐药复发性卵巢癌：AURELIA 试验的探索性分析。
Ann Oncol. 2017 Aug 1;28(8):1842-1848. doi: 10.1093/annonc/mdx228.
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Anti-angiogenesis therapy in gynecologic malignancies.妇科恶性肿瘤的抗血管生成治疗
Oncology (Williston Park). 2015 May;29(5):350-60.
3
Risk factors for GI adverse events in a phase III randomized trial of bevacizumab in first-line therapy of advanced ovarian cancer: A Gynecologic Oncology Group Study.
贝伐珠单抗用于一线治疗晚期卵巢癌的 III 期随机试验中胃肠道不良事件的风险因素：一项妇科肿瘤学组研究。
J Clin Oncol. 2014 Apr 20;32(12):1210-7. doi: 10.1200/JCO.2013.53.6524. Epub 2014 Mar 17.
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Imaging features of bowel toxicities in the setting of molecular targeted therapies in cancer patients.癌症患者分子靶向治疗中肠毒性的影像学特征。
Br J Radiol. 2012 Oct;85(1018):1420-6. doi: 10.1259/bjr/19815818. Epub 2012 Jun 6.
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Management of bevacizumab-associated bowel perforation: a case series and review of the literature.贝伐单抗相关肠穿孔的管理：病例系列及文献综述
Ann Oncol. 2008 Mar;19(3):577-82. doi: 10.1093/annonc/mdm508. Epub 2007 Nov 16.
6
What is the risk of bowel perforation associated with bevacizumab therapy in ovarian cancer?贝伐单抗治疗卵巢癌时肠道穿孔的风险有多大？
Gynecol Oncol. 2007 Apr;105(1):3-6. doi: 10.1016/j.ygyno.2007.01.038.