- 期刊
Successful Management of Bowel Perforation from Bevacizumab for the Treatment of Metastatic Colorectal Cancer: Three Case Reports and Literature Review
成功治療使用癌思停(Bevacizumab)治療轉移性結直腸癌導致之腸穿孔：三例病例報告與文獻綜述
摘要
Bevacizumab (商品名：Avastin 中文名：癌思停) 是一種血管內皮增生因子的單株抗體，它會破壞重要的癌症信號通路和抑制血管生成，因而造成抗腫瘤作用。使用Bevacizumab治療轉移性結腸直腸癌提高了存活率，但仍有一系列之副作用被報導，其中腸穿孔發生率雖然相對較低，大約0.3% 到2.4%，但卻是致命的，死亡率高達15%。我們回顧了單一機構使用Bevacizumab 治療轉移性大腸直腸癌之135 位病患，其中3 位發生腸穿孔，腸穿孔的發生率為2.22%，然而在我們的早期診斷與腸造口之保守手術及抗生素治療後能降低併發症且目前並無死亡之病例。
並列摘要
Bevacizumab is a monoclonal antibody that deactivates the vascular endothelial growth factor leading to disruption of vital cancer-signaling pathways and inhibition of angiogenesis, which results in its anti-tumor activity. The use of bevacizumab increases survival in patients with metastatic colorectal cancer (mCRC), but serious adverse effects of bevacizumab have been reported. Among them, the incidence of bowel perforation is relatively rare, approximately 0.3% to 2.4%, but is an often fatal event. Mortality rates have been reported as high as 15%. We reviewed three cases of bowel perforation from 135 mCRC patients with bevacizumab treatment in one single institute. The incidence of bowel perforation was 2.22% (3/135) from the current study; however, no mortality was found after our early diagnosis and palliative operation as stoma creation, intra-abdominal drain and empiric antibiotics would probably reduce the mortality and morbidity from our limited experience.
延伸閱讀
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