贝伐珠单抗联合化疗治疗4例晚期持续/复发性子宫肉瘤

目的：观察贝伐珠单抗（bevacizumab，BEV）联合化疗治疗晚期持续/复发性子宫肉瘤的临床疗效。方法回顾性分析中国医学科学院肿瘤医院院2006年5月至2014年5月接受贝伐珠单抗与化疗联合治疗的4例晚期持续/复发性子宫肉瘤患者的临床资料，评价治疗的总有效率、临床获益率、无进展生存时间（progres-sion free survival，PFS）和总生存时间（overall survival，OS），并评价治疗的安全性和毒性反应。结果4例患者中，1例达完全缓解，无瘤生存时间为96个月；1例达部分缓解，PFS为13个月，OS为25个月；1例为疾病稳定，PFS为9个月，OS为24个月；1例为疾病进展，PFS为3个月，OS为9个月。治疗总有效率为50％（2/4），临床获益率为75%（3/4），平均PFS为30.25个月，平均OS为38.5个月。4例患者发生的与治疗相关的毒副反应主要是骨髓抑制和胃肠道反应，其中有1例患者为4度血液学毒性（血小板减少），其余3例均为2度骨髓抑制（WBC减少）；非血液学毒性主要是胃肠道反应（恶心、呕吐），其中2例患者为2度，2例患者为1度。结论BEV联合化疗可有效控制晚期持续/复发性子宫肉瘤，且耐受性良好，可作为治疗晚期持续/复发性子宫肉瘤安全、有效的候选方案。

Observation of the curative effect of bevacizumab combined with chemotherapy in 4 cases of advanced or recurrent uterine sarcoma

Objective To observe the clinical effect of BEV combining chemotherapy in advanced or recurrent uterine sarcomas. Method The clinical data of 4 cases of advanced or recurrent uterine sarcoma, who accepted treat-ment of BEV combining chemotherapy in our hospital from May 2006 to May 2014, were analyzed. The overall re-sponse rate (CR+PR), clinical benefit rate (CR+PR+SD), progression-free survival (PFS) and overall survival (OS), and the safety and toxicity reactions were evaluated. Results Of the four patients, one case achieved CR, with a dis-ease-free survival time of 96 months; one case achieved PR, with a PFS of 13 months, and OS was 25 months; one case achieved SD, with a PFS of 9 months, and OS was 24 months; and one case had PD, with a PFS of 3 months, and OS was 9 months. The overall response rate (CR+PR) was 50%, clinical benefit rate (CR+PR+SD) was 75%, the average PFS was 30.25 months, and the average OS was 38.5 months. Treatment-related adverse reactions were bone marrow suppression and gastrointestinal reactions. Of the four patients, one had hematologic toxicities (PLT) of grade Ⅳ, other three cases developed bone marrow suppression (WBC) of grade Ⅱ; In regard of the gastrointestinal reac-tions, 2 cases were in grade Ⅱ, the other two cases were in grade Ⅰ. Conclusion The advanced or recurrent uterine sarcoma can be effectively controlled by BEV combing chemotherapy, and the therapy was well tolerated, which is expected to be a safe and effective candidate treatment for advanced or recurrent uterine sarcoma.