2026 年第 3 期 第 21 卷

微波消融联合贝伐珠单抗治疗表皮生长因子受体酪氨酸激酶抑制剂耐药晚期非小细胞肺癌的有效性及安全性

Efficacy and safety of microwave ablation combined with bevacizumab in the treatment of epidermal growth factor receptor tyrosine kinase inhibitor-resistant advanced non-small cell lung cancer

作者：由媛丽王秀清杨明星董文

英文作者：You Yuanli Wang Xiuqing Yang Mingxing Dong Wen

单位：海南省肿瘤医院呼吸内科，海口570312

英文单位：Department of Respiratory Medicine Hainan Cancer Hospital Haikou 570312 China

关键词：非小细胞肺癌；微波消融；贝伐珠单抗；表皮生长因子受体酪氨酸激酶抑制剂耐药

英文关键词：Non-smallcelllungcancer;Microwaveablation;Bevacizumab;Epidermalgrowthfactorreceptortyrosinekinaseinhibitorsresistance

• 摘要：

• 目的 探讨微波消融联合贝伐珠单抗在表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKI）耐药晚期非小细胞肺癌（NSCLC）中的协同增效作用及安全性。方法 回顾性选取2022年1月至2025年4月海南省肿瘤医院收治的经EGFR-TKI治疗后产生耐药的晚期非鳞状NSCLC患者82例，根据治疗方案分为联合组和对照组，各41例。对照组予培美曲塞/卡铂方案化疗，联合组予微波消融+贝伐珠单抗+培美曲塞/卡铂方案治疗。比较2组近期疗效、血清肿瘤标志物动态变化、远期生存获益及安全性。结果 联合组客观缓解率、疾病控制率均高于对照组［65.8%（27/41）比34.2%（14/41）、90.2%（37/41）比68.3%（28/41）］（均P＜0.05）。治疗后，2组癌胚抗原、CYFRA21-1水平均低于治疗前，且联合组低于对照组（均P<0.05）。联合组中位无进展生存期（PFS）为8.5个月（95%置信区间：7.803~10.397），对照组中位PFS为5.3个月（95%置信区间：4.076~6.524），联合组中位PFS长于对照组（风险比＝0.46，P＜0.01）。联合组与对照组3级以上不良反应发生率比较差异无统计学意义（P＞0.05）。结论 微波消融联合贝伐珠单抗对EGFR-TKI耐药患者有一定协同增效作用，提升肿瘤标志物应答并延长PFS，且安全性可控，为晚期NSCLC提供新型整合治疗方案。

• Objective To explore the synergistic efficacy and safety of microwave ablation combined with bevacizumab in epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI)-resistant advanced non-small cell lung cancer (NSCLC). Methods A retrospective analysis was performed on the clinical data of 82 patients with advanced non-squamous NSCLC who developed resistance to EGFR-TKI treatment and were admitted to Hainan Cancer Hospital from January 2022 to April 2025. According to the treatment regimens, the patients were divided into the combination group and the control group, with 41 cases in each group. The control group received pemetrexed/carboplatin chemotherapy, while the combination group was treated with microwave ablation plus bevacizumab combined with pemetrexed/carboplatin chemotherapy. The short-term efficacy, dynamic changes of serum tumor markers, long-term survival benefits and safety were compared between the two groups. Results The objective response rate and disease control rate in the combination group were significantly higher than those in the control group ［65.8%(27/41) vs 34.2%(14/41), 90.2%(37/41) vs 68.3%(28/41)］(both P<0.05). After treatment, the levels of carcinoembryonic antigen and cytokeratin 19 fragment in both groups were lower than those before treatment, and the levels in the combination group were significantly lower than those in the control group (all P<0.05). The median progression-free survival (mPFS) in the combination group was 8.5 months (95% confidence interval: 7.803-10.397), while that in the control group was 5.3 months (95% confidence interval: 4.076-6.524). The mPFS in the combination group was significantly longer than that in the control group (hazard ratio=0.46, P<0.01). There was no statistically significant difference in the incidence of grade 3 or above adverse reactions between the combination group and the control group (P>0.05). Conclusion Microwave ablation combined with bevacizumab exerts a certain synergistic effect in patients with EGFR-TKI resistance, improves the response of tumor markers, prolongs PFS, and has a controllable safety profile, which provides a novel integrated treatment strategy for advanced NSCLC.