Which factors predict bowel complications in patients with recurrent epithelial ovarian cancer being treated with bevacizumab?
Which factors predict bowel complications in patients with recurrent epithelial ovarian cancer being treated with bevacizumab?
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DOI：
10.1016/j.ygyno.2010.01.011
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发表时间：
2010-07-01
影响因子：
4.7
通讯作者：
O'Malley, D. M.
中科院分区：
文献类型：
--
作者：
Richardson, D. L.;Backes, F. J.;O'Malley, D. M.
背景资料。贝伐单抗治疗复发性上皮性卵巢癌(EOC)患者的肠穿孔发生率增加已有报道，但这种关联的危险因素尚不确定。我们试图找出与贝伐单抗治疗复发性卵巢癌患者肠穿孔和肠瘘形成相关的因素。对在同一机构接受贝伐单抗治疗的所有复发卵巢癌患者进行了图表回顾。收集相关的患者特征和治疗信息。多因素分析采用单因素Logistic回归分析。112名患者接受了160种不同的贝伐单抗方案治疗。中位年龄60岁(范围29-78岁)。患者之前接受过4种化疗方案的中位数(范围为1-10)。中位周期数为4个(0.5~31个)。10例(9%)被诊断为肠穿孔，另外2例(1.8%)被诊断为瘘管。穿孔后30天的死亡率为50%，30%的患者在1周内死亡。有直肠阴道结节的患者比无直肠阴道结节的患者更容易发生肠穿孔或肠瘘，OR=3.64(95%CI=1.1~12.1，P=0.04)。其他变量与肠穿孔或瘘管形成均无显著相关性。接受贝伐单抗治疗的复发性卵巢癌患者，直肠阴道结节与肠穿孔或瘘管形成的风险增加有关。对于有直肠阴道结节的卵巢癌患者，在开始贝伐单抗治疗之前应仔细考虑，因为贝伐单抗相关肠穿孔的死亡率为50%。(C)2010 Elsevier Inc.保留所有权利。
Background. Increased rates of bowel perforation in patients with recurrent epithelial ovarian cancer (EOC) treated with bevacizumab have been reported, but the risk factors for this association are uncertain. We sought to identify factors associated with bowel perforation and fistula formation in recurrent EOC patients treated with bevacizumab.Methods. A chart review of all patients treated with bevacizumab for recurrent EOC at a single institution was performed. Pertinent patient characteristics and treatment information were collected. Univariate logistic regression was performed to analyze multiple variables.Results. One hundred twelve patients who were treated with 160 different bevacizumab regimens were identified. The median age was 60 years (range, 29-78 years). Patients had received a median of 4 prior chemotherapy regimens (range, 1-10). The median number of cycles was 4 (range, 0.5-31). Ten patients (9%) were diagnosed with bowel perforations, and another 2 patients (1.8%) were diagnosed with fistulas. The 30-day mortality following perforation was 50%, with 30% of patients dying within 1 week. Patients with rectovaginal nodularity were more likely to develop a bowel perforation or fistula than those who did not have this finding, OR = 3.64 (95% Cl = 1.1 to 12.1, p = 0.04). None of the other variables were significantly associated with bowel perforations or fistula formation.Conclusions. Rectovaginal nodularity is associated with an increased risk of bowel perforation or fistula formation for patients with recurrent EOC treated with bevacizumab. Careful consideration should be given prior to initiating bevacizumab treatment in EOC patients with rectovaginal nodularity since the mortality rate with bevacizumab associated bowel perforations is 50%. (C) 2010 Elsevier Inc. All rights reserved.