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[抗血管生成药物与高血压:从多学科协作到更优质护理]

[Anti-angiogenic drugs and hypertension: from multidisciplinary collaboration to greater care].

作者信息

Tunesi Francesca, Simonini Marco, Sabetta Giulia, Bergamini Alice, Cioffi Raffaella, Raiabiotti Emanuela, Manunta Paolo, Vezzoli Giuseppe, Mangili Giorgia, Lanzani Chiara Livia

机构信息

U.O. Nefrologia e Dialisi, IRCCS Ospedale San Raffaele, Milano, Italia; Università Vita Salute San Raffaele, Milano, Italia.

U.O. Ginecologia ed Ostetricia, IRCCS Ospedale San Raffaele, Milano, Italia; Università Vita Salute San Raffaele, Milano, Italia.

出版信息

G Ital Nefrol. 2022 Dec 21;39(6):2022-vol6.

Abstract

Anti-angiogenic drugs are widely used in cancer therapy. Their main targets of action are the vascular endothelial growth factor (VEGF) and its receptors (VEGF-R). Anti-angiogenic drugs are used to reduce the growth of the tumor and its metastases by acting on the phenomenon of tumor neo-angiogenesis. However, they are known for their side effects such as hypertension, acute kidney injury (AKI), and congestive heart failure. retrospective study conducted on 57 consecutive patients known for ovarian cancer. Patients treated with Bevacizumab, as first-line, relapse, or maintenance treatment (2015-2022). according to FIGO staging, 98.2% (56 out of 57) of the patients in the study had third degree disease (G3). 49% of patients developed hypertension after starting Bevacizumab therapy (82% grade 2 according to CTCAE v.5). 89% of hypertensive patients started treatment and its management was multidisciplinary with nephrological consultation in 68% of cases. Only 3 out of 57 women discontinued treatment due to hypertension, and in only one of them it was not possible to restart it. the evaluation of the patient by a multidisciplinary team (gynecologist and nephrologist) is essential to minimize the morbidity and mortality of patients, and to avoid the interruption of antineoplastic treatment.

摘要

抗血管生成药物广泛应用于癌症治疗。它们的主要作用靶点是血管内皮生长因子(VEGF)及其受体(VEGF-R)。抗血管生成药物通过作用于肿瘤新生血管生成现象来减少肿瘤的生长及其转移。然而,它们以高血压、急性肾损伤(AKI)和充血性心力衰竭等副作用而闻名。对57例连续确诊为卵巢癌的患者进行了一项回顾性研究。这些患者接受贝伐单抗治疗,作为一线、复发或维持治疗(2015 - 2022年)。根据国际妇产科联盟(FIGO)分期,研究中的患者98.2%(57例中的56例)患有三度疾病(G3)。49%的患者在开始贝伐单抗治疗后出现高血压(根据CTCAE v.5,82%为2级)。89%的高血压患者开始接受治疗,其管理是多学科的,68%的病例进行了肾脏科会诊。57名女性中只有3人因高血压停药,其中只有1人无法重新开始治疗。由多学科团队(妇科医生和肾脏科医生)对患者进行评估对于将患者的发病率和死亡率降至最低以及避免抗肿瘤治疗中断至关重要。

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