Bevacizumab在晚期子宮頸癌的檢視

The role of bevacizumab for rescue therapy of cervical cancer

雖然早期子宮頸癌的治療成效好，但對於持續、復發或轉移性的子宮頸癌則是一項艱鉅的挑戰。在婦癌研究組240報告，此乃一隨機、有控制組、開放性的第3期研究，登錄452位子宮頸癌患者（單獨化學藥物治療者有225位、化學藥物中加bevacizumab治療者有227位），在化學藥物合併bevacizumab治療組全部生存時間較單獨化學治療組，多存活4個月，但副作用嚴重，甚至有致命性。最近幾篇文獻報告，研究bevacizumab在放射線治療前、後使用，會增加瘻管風險，因此如以前曾接受過放射線治療者，並不適合以bevacizumab作為救援治療。

Athough the treatment of early-stage cervical cancer is very successful, it is still a big challenge in the management of persistent, recurrent or metastatic cervical cancer. A randomized, controlled, open-label, phase 3 trial (Gynecologic Oncology Group 240) enrolling 452 cervical patients (225 for chemotherapy alone and 227 for chemotherapy plus bevacizumab) found the combination of chemotherapy and bevacizumab therapy provided a significant improvement in overall survival by 4 months, but adverse effects were often severe and sometimes fatal. Recently, several articles reported that using bevacizumab before or after radiotherapy increased the risk of fistula formation in patients with cervical cancer. Therefore, previous radiation patients may not be a good candidate to consider the adding bevacizumab for rescue therapy.