黄英,罗明,杨志勇
HUANG Ying,LUO Ming,YANG Zhiyong

• 1:上海交通大学附属新华医院崇明分院肿瘤内科
• 2:上海交通大学附属新华医院崇明分院神经外科

摘要(Abstract)：

目的:探讨贝伐珠单抗联合替莫唑胺对胶质瘤放疗患者脑水肿及神经功能的影响。方法:60例胶质瘤手术后行放化疗患者均分为观察组和对照组,对照组采用替莫唑胺治疗,观察组采用贝伐珠单抗联合替莫唑胺治疗;于治疗前及治疗6个周期时,比较2组患者的脑水肿带宽度、采用脑卒中量表(NIHSS)及改良认知评估量表(ACE-R)评价2组患者的神经功能、采用癌症患者生命质量量表(EORTIC QLQ-C30)评价2组患者的生活质量;记录2组患者治疗期间高血压、蛋白尿、白细胞减少、发热及腹泻等不良反应。结果:观察组患者治疗后疾病控制效率(53.3%)高于对照组(26.7%)、脑水肿带宽度低于对照组,差异有统计学意义(P <0.05);治疗后2组NIHSS评分低于治疗前、ACE-R评分高于治疗前,观察组更明显,差异有统计学意义(P <0.05);治疗后观察组EORTIC QLQ-C30量表的整体生存质量、功能领域评分高于对照组,症状领域评分低于对照组,差异有统计学意义(P <0.05);治疗期间2组患者不良反应发生率比较,差异无统计学意义(P> 0.05)。结论:贝伐珠单抗联合替莫唑胺对胶质瘤术后放疗患者脑水肿的改善作用优于单一的替莫唑胺治疗,可进一步改善患者神经功能和生活质量。
Objective: To investigate the effect of bevacizumab combined with temozolomide on cerebral edema and neurological function in glioma patients with radiotherapy. Methods: Sixty glioma postoperation patients with radiotherapy and chemotherapy were randomly divided into observation group and control group with 30 cases each. The observation group was treated with bevacizumab combined with temozolomide,and the control group with temozolomide. Cerebral edema band width,neurological function evaluated though NIH stroke scale( NIHSS) and ACE-R, and life quality evaluated through EORTIC QLQ-C30,were compared between two groups before and after 6-cycle treatment; record the adverse reactions in two groups during the treatment,such as hypertension,albuminuria, hypoleucocytosis, fever and diarrhoea. Results: After treatment, disease control efficiency of the observation group was higher than that of the control group( 53. 3% vs 26. 7%) and edema band width of the observation group was narrower than that of the control group; the difference was statistically significant( P < 0. 05). The NIHSS scores of both groups decreased and the ACE-R scores of both groups increased compared with those before treatment,among which the observation group had higher scores,and the difference was statistically significant( P < 0. 05). The scores in EORTIC QLQ-C30 reflecting life quality and function-related scores of the observation group were higher than those of the control group,and the symptom-related scores were lower than those of the control group; the difference was statistically significant( P < 0. 05). During treatment,incidence rate of adverse reactions of the observation group was compared with that of the control group and there was no statistical significance( P > 0. 05). Conclusion: Bevacizumab combined with temozolomide has better effect on easing cerebral edema in glioma patients with radiotherapy than temozolomide,which helps to further improve their neurological function and life quality.

关键词(KeyWords)： 神经胶质瘤;脑水肿;脑损伤;抗体,单克隆;血管内皮生长因子类;贝伐珠单抗
glioma;brain edema;brain injuries;antibodies,monoclonal;vascular endothelial growth factors;bevacizumab(BEV)

Abstract:

Keywords:

基金项目(Foundation): 上海市卫生健康委员会科研课题计划(201940274)

作者(Author): 黄英,罗明,杨志勇
HUANG Ying,LUO Ming,YANG Zhiyong

DOI: 10.19367/j.cnki.2096-8388.2020.10.019

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