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贝伐单抗治疗晚期肺鳞状细胞癌患者脑放射性坏死:一例报告

Brain radiation necrosis treated with bevacizumab in a patient with advanced squamous cell lung carcinoma: A case report.

作者信息

Gan Kelun, Zeng Beilei, Chen Hong, Meng Shan, Ma Daiyuan

机构信息

Department of Oncology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China.

School of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China.

出版信息

Oncol Lett. 2024 Dec 10;29(2):98. doi: 10.3892/ol.2024.14844. eCollection 2025 Feb.

Abstract

Brain radiation necrosis is a serious adverse effect of radiotherapy in patients with malignant brain metastases. There is currently no standard treatment for brain radiation necrosis; however, there are advantages to using bevacizumab. Nonetheless, due to the risk of severe bleeding when bevacizumab is used in patients with squamous cell lung carcinoma, relevant clinical studies are lacking; therefore, there is no clear conclusion on the use of bevacizumab to treat brain radiation necrosis in patients with squamous cell carcinoma of the lung with brain metastases. The present study described the case of a patient treated with bevacizumab after brain radiation injury with pathological manifestations diagnosed as squamous cell carcinoma of the lung. Through the evaluation of clinical symptoms and imaging data, the patient was diagnosed with cerebral radiation necrosis a few months after receiving local radiotherapy for intracranial metastatic lesions. After four cycles of treatment with bevacizumab (7.5 mg/kg once every 3 weeks, intravenous drip), the clinical and imaging manifestations of the patient were considerably improved with no significant adverse effects. The favorable efficacy and safety profiles of this patient suggest that bevacizumab holds potential as a future therapeutic option for managing radiation-induced brain necrosis in patients with squamous cell lung cancer.

摘要

脑放射性坏死是恶性脑转移瘤患者放疗的严重不良反应。目前对于脑放射性坏死尚无标准治疗方法;然而,使用贝伐单抗有一定优势。尽管如此,由于在鳞状细胞肺癌患者中使用贝伐单抗时有严重出血风险,相关临床研究较少;因此,对于使用贝伐单抗治疗伴有脑转移的肺鳞状细胞癌患者的脑放射性坏死尚无明确结论。本研究描述了1例脑放射损伤后接受贝伐单抗治疗、病理表现诊断为肺鳞状细胞癌患者的病例。通过对临床症状和影像资料的评估,该患者在接受颅内转移瘤局部放疗数月后被诊断为脑放射性坏死。在接受4个周期的贝伐单抗治疗(7.5mg/kg,每3周静脉滴注1次)后,患者的临床和影像表现有显著改善,且无明显不良反应。该患者良好的疗效和安全性表明,贝伐单抗有望成为未来治疗肺鳞状细胞癌患者放射性脑坏死的一种治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7a2a/11656793/00c4154e30ed/ol-29-02-14844-g00.jpg

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