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发表于 2011-7-18 01:55:37
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来自： 中国广东广州
本帖最后由 chris_mac 于 2011-7-18 01:56 编辑
附上资料原文，是来自cancergrace.org上一个医生对病人的咨询回复。
I have a treatment plan in place with Cisplatin/Gemzar. The last time I received this regimen, I had a great response with limited side effects, but Avastin was included in the combo (2006). My onc feels there is some question about adding Avastin to the mix this time. I think because the of the location of the tumor which is pressing into the esophagus and also because of the max dosage of radiation I have received to that area. What are the parameters of prescribing Avastin? I did take it as a single agent at half dose in 2009 because of trouble with headaches and HBP. It kept things stable for over a year, but stopped because I needed a break and began to see gradual progression within a couple of months.
—— Myrtle
Another concern is that we have seen a concerning frequency of complications when avastin and chest radiation are given at the same time, and perhaps even when they're given sequentially. The leading concern is a tracheo-esophageal fistula, which is a hole that connects the airway (trachea) to the esophagus, both running alongside of each other through the middle of the chest. This can be a fatal complication and has been seen more commonly when avastin is given along with chest radiation. It's certainly something to be aware of and consider when going through the potential risks and benefits of adding chest radiation for someone still getting, and maybe even just with a history of getting, avastin.
There isn't a clear contraindication based on location or prior radiation, but that doesn't mean it's proven to be totally safe. Many lung cancer specialists and some general oncologists have become increasingly wary about combining significant chest radiation with Avastin (bevacizumab), especially concurrently but even possibly sequentially, due to an observation of more tracheoesophageal fistulas. I would be doubly wary in someone who had received more than a standard amount of radiation to the chest.
Another issue is that there is no evidence of any benefit for Avastin being repeated in someone who has received and progressed on it at any time in the past. The only place where it has really been proven to be effective (and even then, only improving survival in one of the two large studies) has been as first line therapy in combination with chemotherapy in treatment-naive patients.
—— Dr. West |
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发表于 2011-7-18 10:22:39
