Prevention of the adverse reaction application of bevacizumab in combination with chemotherapy in postoperative patients with gastric cancer

Abstract

Objective To investigate the adverse reaction of gastric cancer patients after inquiry application of bevacizumab combined with chemotherapy, and put forward some corresponding preventive measures. Methods Sixty-five cases patients with gastric cancer who were treated with advanced gastric cancer radical operation application of bevacizumab in combination with chemotherapy in the Central Hospital of Jiangmen from January 2012 to January 2014, including 41 male, 24 female, with the average age of 48.7 years old.The adverse reactions were observed, and give the corresponding prevention and control measures on the basis of the adverse reaction conditions, the experience in the prevention and treatment were summarized according to the therapeutic effect with clinical and related literature. Results The adverse reactions caused by bevacizumab combined with chemotherapy in patients with gastric cancer including proteinuria(a total of 24 cases(37%), including 18 cases(27.8%) of (+ ), 6 cases(9.2%) of (+ + )), gastrointestinal reaction(a total of 10 cases(15.4%), including 8 cases(12.3%) of grade Ⅰ, 2 cases(3.1%) of grade Ⅱ), thrombosis(a total of 20 cases(30.7%), including 13 cases of grade Ⅰ(20%), 7 cases(10.7%) of grade Ⅱ) and hypertension(a total of 11 cases(16.9%), including 9 cases(13.8%) of grade Ⅰ, 2 cases(3.1%) of grade Ⅱ). Bevacizumab combined with chemotherapy in the treatment of gastric cancer patients with partial remission in 41 cases(63.1%), 10 cases(15.4%) of stable disease progression, 14 cases(21.5%) of disease progression, the complete remission rate was 63.1%.For adverse reactions of proteinuria, patients with asymptomatic proteinuria, if patients with urinary protein detection results for (+ ), without special treatment, when patients with urinary protein detection for (+ + ), given the observation, if patients with urinary protein was more than or equal to 2 g/24 h, paused bevacizumab until proteinuria<2 g. When the patients with digestive system damage, such as ALT and AST elevation, given the treatment of liver until the two hepatic enzymes returned to normal; patients with gastrointestinal reactions were nausea and vomiting, asked patient to light diet and regular esophagoscopy, if the patients appeared visceral fistula immediately stopped bevacizumab.For patients with thrombosis, should be closely monitored in patients with signs, once found regardless of any level of embolism events, all immediately stopped the chemotherapy drugs.For the main adverse reactions of hypertension, given patients with proper medication explain before the treatment to reduce the fear, tension, and avoiding mood disorders which lead to an increase in blood pressure, blood pressure should be regularly detected in patients who use drugs, if patients occurred a sharp rise in blood pressure during the treatment, immediately stopped bevacizumab and given antihypertensive treatment. Conclusion Clinicians should take the possible corresponding prediction in patients underwent application of bevacizumab in combination with chemotherapy on the possible different adverse reactions according to the actual situation of patients, and take corresponding preventive measures, can to some extent avoid serious adverse reaction occurred, and improve the quality of life of the patients. Key words: Gastric cancer; Chemotherapy; Adverse reaction; Bevacizumab