Bai Xuexue, Zhou Meng
Neurosurgery of The First Affiliated Hospital, Jinan University, Guangzhou, China.
Front Oncol. 2022 Sep 29;12:838670. doi: 10.3389/fonc.2022.838670. eCollection 2022.
This retrospective study investigated the efficacy of bevacizumab in refractory brain edema caused by brain metastasis from lung cancer and colon cancer.
A total of 72 patients with refractory brain edema were divided into the lung cancer and colon cancer groups according to their primary tumor. All patients received a single bevacizumab treatment for refractory brain edema. MRI was performed 1 week before the treatment and 4 weeks after the treatment. The edema and tumor volumes were calculated using imaging modalities.
After a single bevacizumab treatment, the refractory brain edema of 61 patients was controlled, and the clinical symptoms of 65 patients were improved. The average edema volume before treatment was 201,708.97 ± 61,426.04 mm, which has decreased to 116,947.01 ± 43,879.16 mm after treatment (P < 0.05). After treatment, the edema index decreased from 25.97 ± 7.15 to 17.32 ± 5.24 (P < 0.05).We found that brain edema was controlled in 40 patients (93.02%) in the lung cancer group and 21 patients (72.41%) in the colon cancer group (P<0.05). In addition, 22 patients (88.00%) in the radiotherapy group achieved edema control, compared to 39 (82.98%) in the non-radiotherapy group (P>0.05). Nine patients experienced hypertension after treatment, two patients exhibited decreased platelet counts, and no hemorrhage cases were observed.
Bevacizumab can significantly alleviate refractory brain edema, and there is a significant difference in the efficacy of bevacizumab on refractory brain edema caused by brain metastasis from lung and colon cancers.
本回顾性研究探讨了贝伐单抗治疗肺癌和结肠癌脑转移所致难治性脑水肿的疗效。
将72例难治性脑水肿患者按原发肿瘤分为肺癌组和结肠癌组。所有患者均接受单次贝伐单抗治疗难治性脑水肿。在治疗前1周和治疗后4周进行MRI检查。使用成像方式计算水肿和肿瘤体积。
单次贝伐单抗治疗后，61例患者的难治性脑水肿得到控制，65例患者的临床症状得到改善。治疗前平均水肿体积为201708.97±61426.04mm，治疗后降至116947.01±43879.16mm（P<0.05）。治疗后，水肿指数从25.97±7.15降至17.32±5.24（P<0.05）。我们发现肺癌组40例患者（93.02%）的脑水肿得到控制，结肠癌组21例患者（72.41%）的脑水肿得到控制（P<0.05）。此外，放疗组22例患者（88.00%）实现了水肿控制，非放疗组为39例（82.98%）（P>0.05）。9例患者治疗后出现高血压，2例患者血小板计数下降，未观察到出血病例。
贝伐单抗可显著减轻难治性脑水肿，且贝伐单抗对肺癌和结肠癌脑转移所致难治性脑水肿的疗效存在显著差异。
