Background and objective: Bevacizumab has showed its efficacy in advanced non-squamous lung cancer. The aim of this study is to assess the safety of bevacizumab plus pemetrexed and carboplatin neoadjuvant chemotherapy in patients with lung adenocarcinoma.
Methods: 25 patients with IIIa lung adenocarcinoma undergoing lobectemy or pneumonectomy with mediastinal lymphadenectomy after induction bevacizumab (Bev) plus pemetrexed/carboplatin (PC) were selected. Toxicity of chemotherapy and postoperative complications were analyzed.
Results: Grade 3 or 4 neoadjuvant-related adverse events included fatigue (3 patients), neutropenia (3 patients), hypertension (1 patient). The adverse events thought to be related to bevacizumab included epistaxis in 2 patients (grade 1: 1; grade 2: 1) and hypertension in 3 patients (grade 1: 2; grade 3: 1). Postoperative complications included pneumonia in 2 patients, bronchial stump insufficiency in 1 case, atelectasis in 2 cases, and arrhythmia in 1 case. Hemorrhage events, thromboembolic events and wound-healing problems were not observed in the perioperative period.
Conclusions: The treatment modality of neoadjuvant Bev-PC appears to be safe and tolerant in patients with stage IIIa lung adenocarcinoma.
背景与目的 贝伐珠单抗联合化疗在晚期肺腺癌治疗中已取得较好疗效，本研究探讨贝伐珠单抗联合培美曲塞加卡铂方案作为IIIa期肺腺癌患者的新辅助方案对手术安全性的影响。方法 选择在中山大学肿瘤防治中心应用贝伐珠单抗联合培美曲塞加卡铂方案进行新辅助化疗的IIIa期肺腺癌患者25例，所有病例均在新辅助化疗2周期后，接受肺叶或者全肺叶切除加纵隔淋巴结清扫术。分析患者在化疗期间的毒性反应以及患者在围手术期间的并发症。 结果 与新辅助化疗相关的3级-4级的不良事件包括3例疲劳事件、3例嗜中性白血球减少症和1例高血压。认为与贝伐珠单抗相关的不良事件包括2例鼻出血（1例1级、1例2级）和3例高血压（2例1级、1例3级）。在围手术期出现的并发症包括肺炎（2例）、支气管残端瘘（1例）、肺不张（2例）和心律失常（1例）。围手术期没有观察到既往贝伐珠单抗联合化疗中常见的出血事件、血栓事件以及伤口愈合问题的发生。结论 贝伐珠单抗联合培美曲塞加卡铂作为新辅助化疗方案是对于IIIa期肺腺癌患者来说是安全的，可以耐受的。.