Analysis Of Cardio-Cerebrovascular Adverse Events Of Antiangiogenic Drugs In The Treatment Of Brain Metastasis From Lung Cancer

Objectives To observe the incidence of cardio-cerebrovascular adverse events of antiangiogenic drugs in the treatment of brain metastasis from lung cancer,and analyze the factors that affect the occurrence of adverse events.Methods Retrospective analysis of 182 patients in our Hospital from September 2012 to September 2020.According to whether the patients had received antiangiogenic drug therapy after brain metastasis,they were divided into the antiangiogenic drug therapy group and the control group(who did not receive antiangiogenic drug therapy).Statistical methods were used to analyze the incidence of cardiovascular and cerebrovascular adverse events after treatment and explore the influencing factors of adverse events.Results Among 182 patients with brain metastases from lung cancer,there were 80 patients in the antiangiogenic drug therapy group and 102 patients in the control group.In the antiangiogenic drug therapy group,there were 36 cases of hypertension,6 cases of cerebral hemorrhage and 1 case of cerebral infarction,while in the control group,there were 24 cases of hypertension,0 cases of cerebral hemorrhage,cerebrovascular accident and cerebral infarction.Compared with hypertension(P<0.05),cerebral hemorrhage(P<0.05)and cerebrovascular accident(P<0.05),the difference was statistically significant.The 13 patients in the experimental group had malarrhythmia compared with 3patients in the control group(P<0.05)was statistically significant.The incidence of cardiocerebrovascular adverse events in three commonly used drugs,bevacizumab,endostar and amlotinib,were 55.6%,53.3% and 61.1%,there was no significant difference(P<0.05).The incidence of cardio-cerebrovascular adverse events of AP,GP,TP,EP and IP in combined chemotherapy regimens were 62.5%,66.7%,50%,57.9% and 60%,there was no significant difference among several combined chemotherapy regimens(P>0.05).The incidence of low-grade hypertension after antiangiogenic therapy was 69.2% in patients with a history of hypertension and 33.3% in patients without a history of hypertension,and the difference was statistically significant(P>0.05).The incidence of cardiocerebrovascular adverse events in the experimental group was 40.0% in the patients receiving radiotherapy and 17.5% in the patients not receiving radiotherapy,showing no statistically significant increase(P>0.05).The incidence of other adverse reactions in the experimental group,such as myelosuppression,proteinuria,hemorrhage,fatigue and gastrointestinal reaction,was 30.0%,15.0%,22.5%,35.0%,30.0%,respectively,while that in the control group was 27.5%,2.9%,24.5%,24.5%,25.5%,respectively.The incidence of albuminuria and hemorrhage was significantly increased(P>0.05),the other differences were not statistically significant.Conclusions Antiangiogenic drugs in the treatment of brain metastasis from lung cancer increase the incidence of cardio-cerebrovascular adverse events,but most of them are Ⅰ-Ⅱgrade.The high incidence of adverse events for patients with previous history of hypertension.Clinicians should strengthen supervision to avoid the occurrence of serious adverse consequences.Different types of antiangiogenic drugs have similar safety in cardio-cerebrovascular aspects.The combination with different chemotherapy regimens did not show the difference of cardio-cerebrovascular side effects.Figure 0;Table 5;Reference 170...