以paclitaxel + carboplatin + bevacizumab藥物組合治療非小細胞肺癌患者：跨科別專家臨床共識

Combination of Bevacizumab with Paclitaxel and Carboplatin in the Treatment of Non-Small Cell Lung Cancer: Multidisciplinary Consensus

PCB (paclitaxel + carboplatin + bevacizumab)藥物組合對於NSCLC (non-small cell lung cancer)的療效已獲諸多臨床試驗及觀察性試驗證實，且用於中樞神經系統轉移及合併惡性積水的患者亦有優良療效；不過在高齡患者的療效目前仍有歧異，故建議在挑選藥物時應將年齡及日常體能狀態共同納入考量。在安全性方面，接受PCB治療後所產生的不良反應大多可獲妥善處置，且大多數患者發生後仍可繼續接受治療。臨床使用時應依照NCCN準則確實給予預防用藥，以降低嘔吐、過敏等不良反應之發生率；且預防用藥與PCB之間的間隔需達30分鐘以上，以確保有足夠的時間讓藥效發揮。針對個別藥物可能產生的不良反應，在施打PCB時應多加留意；並配合出院後的專業護理師衛教及生活型態調整，盡可能使患者得以繼續接受治療。

Efficacy of combination regimen of paclitaxel, carboplatin, and bevacizumab (PCB) in the treatment of non-small cell lung cancer (NSCLC) has been well established in an ample amount of clinical trials and real-world investigations. While proven to be efficacious in patients with CNS metastases and malignant effusion based on clinical evidence and real world experiences, efficacy of PCB regimen in the elderly population remains to be determined. Thus, both age and performance status should be considered in treatment decision. PCB treatment-related adverse events are generally manageable, and most patients are able to continue treatment. NCCN guidelines for pre-medication should be followed to lower the risk of adverse events such as vomiting and hypersensitivity. Moreover, at least a 30-minute interval between pre-medication and PCB regimen should be adhered for the pre-medication to take effect. In addition to monitoring drug-specific adverse events with vigilance during PCB treatments, providing detailed patient care education and life-style adjustment suggestions are viable measures to extend treatment duration.