| Objectives:Brain metastasis is a common disease with serious harm.The median survival time is 3-7 months.Stereotactic radiotherapy has an irreplaceable advantage in the treatment of brain metastasis.In this study,the Observation group and the control group were set up to evaluate the effect of bevacizumab combined with stereotactic radiotherapy in improving peritumoral edema and radiosensitization in the treatment of brain metastasis,to observe the clinical efficacy and safety of bevacizumab combined with stereotactic radiotherapy.Methods:The data of 40 cancer patients with brain metastases treated by stereotactic radiotherapy in the First People’s Hospital of Yunnan Province from January 2020 to December 2022 were analyzed.The patients treated with stereotactic radiotherapy and bevacizumab were included in the Observation group.The patients treated with stereotactic radiotherapy alone were included in the control group,and the other treatments of the two groups were similar.The indexes such as Karnofsky score,metastatic tumor volume,peritumoral edema volume and edema index were recorded before treatment,imaging evaluation was performed 1 month after treatment,and Karnofsky score was evaluated again,and adverse reactions were followed up at the same time.In this study,SPSS26.0 statistical software was used for statistical analysis,and the counting data were tested by chi-square(x~2)test.The measurement data in accordance with normal distribution were expressed by mean±standard deviation(x±s),and the comparison of measurement data between groups was carried out by t-test(P<0.05).Results:A total of 40 cases were included in this study,There were 21 cases in the Observation group and 19 cases in the control group.and all patients were evaluated after complete treatment.The results of the Observation group showed that there were 2 cases of CR,17 cases of PR,1 case of SD and 1 case of PD,with ORR of 90.48%(19/21).The results of the control group showed that there were 0 cases of CR,14 cases of PR,2 cases of SD,3cases of PD,with ORR of 73.68%(14/19).There was no significant difference in the ORR of metastatic tumors between the two groups(P>0.05).After treatment,the peritumoral edema volume in the Observation group decreased to(9.93±10.48)cm~3,with an average reduction of(52.62±56.67)cm~3,with a reduction percentage of(80.90±21.83)%;while in the control group,the peritumoral edema volume decreased to(39.71±58.91)cm~3,with an average reduction of(6.23±37.85)cm~3,with a reduction percentage of(26.82±62.75)%,There were significant differences between the two groups(P<0.05).After treatment,the edema index in the Observation group decreased by 10.86±25.69,while that in the control group increased by 3.76±20.20.There was significant difference in edema index between the two groups(P<0.05).After treatment,the Karnofsky score and GPA score of brain metastasis increased by 16.19±8.65 and 0.55±0.38 in the Observation group;and 8.42±11.19 and 0.05±0.40 in the control group,respectively.There was significant difference between the two groups(P<0.05).At the same time,the effect of biological effective dose on the curative effect was compared,and the results showed no significant difference.During the follow-up,a total of 23 patients had adverse reactions related to anti-tumor therapy,the main adverse reactions were myelosuppression,digestive symptoms,headache,abnormal liver and kidney function,secondary hypertension only occurred in the Observation group,a total of 4patients developed hypertension,accounting for 19.05%.Two patients in the two groups had grade 3 myelosuppression,and no grade 4 adverse reactions and deaths were found.Conclusion(s):Bevacizumab combined with stereotactic radiotherapy in the treatment of brain metastases can effectively reduce peritumoral edema,increase patients’Karnofsky score and GPA score,and alleviate clinical symptoms and improve prognosis to a certain extent.No serious adverse reactions occurred,and it was safe and reliable. |
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