新辅助化疗治疗恶性胶质瘤的初步探讨  

Exploration of neoadjuvant chemotherapy for glioma

作　　者：李鹏[1] 李文良[1] 佘春华[1] 孙增峰[1] 

机构地区：[1]天津医科大学肿瘤医院脑系肿瘤科,国家肿瘤临床医学研究中心,天津市肿瘤防治重点实验室,300060

出　　处：《中华神经外科杂志》2015年第2期181-183,共3页Chinese Journal of Neurosurgery

摘　　要：目的 观察尼莫司汀（ACNU）和顺铂（CDDP）联合应用治疗恶性胶质瘤的有效性和安全性,分析新辅助化疗治疗恶性胶质瘤的可行性.方法 （1）回顾性分析2005年1月至2012年1月ACNU联合CDDP72h持续静咏灌注化疗与口服替莫唑胺治疗恶性胶质瘤的短期疗效及1年生存率的差异.（2）分析上述两种化疗方案的不良反应.结果（1）联合化疗短期疗效优于口服替莫唑胺,前者缓解率为56％,后者缓解率为6％（P＜0.01）;联合治疗组1年生存率为28％,替莫唑胺组为19％,两者差异无统计学意义（P＞0.05）.（2）联合治疗组的骨髓抑制较替莫唑胺组明显,前者Ⅲ度以上白细胞减少18例（72％）,Ⅲ度以上血小板减少14例（56％）,而替莫唑胺组未发现Ⅲ度以上骨髓抑制,两组差异具有统计学意义（P＜0.01）.所发生的骨髓抑制均在可耐受的范围内,其余不良反应两组均不明显.结论 与口服替莫唑胺相比,虽然ACNU联合CDDP 72 h化疗的1年生存率及不良反应无明显优势,但其短期疗效显著,可在短时间内缩小肿瘤浸润范围,因而可能更适用于手术前,以提高全切除率,并降低复发率.Objective To explore the effects of ACNU combined with CDDP in malignant glioma treatment,and analyze the clinical validity and safety of drug combination,and to investigate theory evident for the clinical treatment with neoadjuvant chemotherapy.Methods （1） Analyzed the short-term effects and one year survival rate of ACNU and cisplatin intravenous infusion for 72 h and temozolomide （TMZ） chemotherapy retrospectively.（2） Assessed chemotherapy-related toxicity of different groups.Results （1）The short-term effect of ACNU and cisplatin combination chemotherapy was better than that of TMZ therapy,the partial response rate of the former was 56%,while the later was only 6% （P 〈0.01）,but there was no significant difference in one-year survival rate between two groups（28% versus 19%） （P 〉 0.05）.（2） T1e mydosupression was higher in ACNU and cisplatin combination chemotherapy group （grade Ⅲ leucopenia and thrombocytopenia was 72% and 56% respectively）than that in TMZ therapy group（grade Ⅲ leucopenia and thrombocytopenia were all 0%）,but it was tolerable.The other side effects including myelosuppression,damage of liver and kidney were all mild in both groups Conclusions ACNU and cisplatin combination chemotherapy was not better than TMZ in one-year survival time or toxicity.But it showed special advantages in short-term effect which could reduce ttumor invasion in a short time range.This made it more suitable for neoadjuvant chemotherapy to improve the total tumor removal rate and get lower recurrence rate.

关 键 词：神经胶质瘤 尼莫司汀 顺铂 新辅助化疗 

分 类 号：R739.41[医药卫生—肿瘤]