Relationship Between Tumoral Cavitation And Disease Progression-free Survival In Metastatic Or Recurrent Lung Adenocarcinoma Treated With Bevacizumab

Objective:To explore the frequency of tumoral cavity formation during the treatment of bevacizumab in metastatic or recurrent lung adenocarcinoma and to analyze the relationship between tumoral cavitation and disease progression-free survival(PFS)and the ratio of cavity volume to tumor volume and PFS in patients with cavitation.Method:Data of patients with metastatic or recurrent lung adenocarcinoma who were firstly treated with bevacizumab combined with paclitaxel and carboplatin at Yibin Hospital of West China Hospital of Sichuan University from January 2018 to November 2019 were collected.The patients were given bevacizumab combined with chemotherapy at least 4-6 cycles,then followed by bevacizumab alone,and reached disease progression.The clinical data were obtained including the patient's name,gender,age,height,weight,smoking history,EGFR mutation status,telephone number,pathological type,bone metastases,detailed therapeutic regimen,date of chemotherapy,formation of tumoral cavitation,date when cavities begin to form,the date when cavities are maximum,and the date that disease progresses.The progresson-free survival of the disease was evaluated according to the RECIST 1.1 standard.The target area of tumor and tumoral cavities were outlined through the Treatment Planning System(TPS),and the system automatically calculated the volume of tumor and tumoral cavities.Data were statistically analyzed by using SPSS 22.0 statistical software.Result:33 patients were included,7 patients(21.21%)developed tumoral cavitation during bevacizumab combined with chemotherapy.Univariate Cox analysis showed that the median PFS in patients with and without cavity,body mass index<24 and body mass index?24 were statistically significant.The median PFS was 10.33 vs 6.53(P=0.023),8.13 vs 6.16(P=0.008)respectively.Multivariate Cox risk proportional regression results show that the partial regression coefficient between cavity and disease progression-free survival was 0.971(P=0.052).There were no significant differences in the formation of tumoral cavitation in patients with metastatic or recurrent lung adenocarcinoma treated with bevacizumab in terms of gender,age,body mass index,smoking history,EGFR mutation,baseline tumor volume,bone metastasis,and Ki67%(P>0.05).There was no correlation between the progression-free survival and the date of cavitation begin to form,the date of maximum cavity formation or the ratio of cavity maximum volume to tumor volume.Conclusion:1.The present study of 33 patients with metastatic or recurrent lung adenocarcinoma treated with bevacizumab combined with paclitaxel and carboplatin demonstrated that 21.21%(7/33)of the patients developed cavitary lesions.2.After treatment with bevacizumab combined with paclitaxel and carboplatin,patients with cavitation have a longer PFS trend than those without cavitation.3.The ratio of cavity volume to tumor volume has the potential to become an indicator of curative effect evaluation.