影像生物标志物联合贝伐珠单抗在胶质母细胞瘤诊治中的价值  

Application value of imaging biomarker combined with bevacizumab in the diagnosis and treatment of glioblastoma

作　　者：王翠英[1] 张文燕[1] 赵宝帅 崔静[2] 景岳 

机构地区：[1]衡水市第四人民医院肿瘤内科,河北衡水053000 [2]哈励逊国际和平医院耳鼻喉科,河北衡水053000

出　　处：《中国临床研究》2017年第4期437-440,共4页Chinese Journal of Clinical Research

基　　金：河北省医学科学研究重点课题计划(20150030)

摘　　要：目的研究影像生物标志物联合贝伐珠单抗在胶质母细胞瘤诊断及治疗中的应用及其价值。方法选取2011年1月至2013年6月在衡水市第四人民医院和哈励逊国际和平医院住院并接受手术治疗的胶质母细胞瘤患者38例,随机分为两组。术后两组均给予放疗,同时观察组20例同步采用静脉滴注贝伐珠单抗进行治疗,对照组18例同步采用口服替莫唑胺治疗。对比分析两组患者在不同时相(T_0、T_1、T_2、T_3)的相对脑血容量(r CBV,动态磁敏感对比磁共振成像检查获得)、容积转换常数(K^(trans),磁共振动态增强成像检查获得)和18氟标记的半乳糖化精氨酸-甘氨酸-天冬氨酸多肽正电子发射断层显像扫描获得的最大标准摄取值(SUV_(max))、平均标准摄取值(SUV_(mean))和靶比本值(T/NT)等各指标的变化,并分析两组患者的疗效及中位无进展生存期(PFS)、总体生存期(OS)。结果 T_0时,两组间r CBV、K^(trans)、SUV_(mean)、SUV_(max)和T/NT水平比较,差异无统计学意义(P均>0.05);随着T_0→T_1→T_2→T_3的时间推移,两组rCBV、K^(trans)、SUV_(mean)、SUV_(max)和T/NT水平呈降低趋势,差异有统计学意义(P<0.01,P<0.05),且T_1、T_2、T_3时观察组各指标水平均低于对照组(P<0.05,P<0.01)。在随访6、12和24个月时,观察组患者的客观缓解率(ORR)均较对照组有所提高,但差异无统计学意义(P均>0.05)。观察组患者的中位PFS为14.1个月,明显高于对照组的8.4个月(P<0.05)。两组患者的中位OS相当(P>0.05)。结论观察影像生物标志物的改变,可对胶质母细胞瘤患者的病情做出较为准确的评估。同时联合贝伐珠单抗治疗,可一定程度延长胶质母细胞瘤患者的生存期。Objective To investigate the application of imaging biomarker combined with bevacizumab in the diagnosis and treatment of glioblastoma and its clinical value. Methods A total of 38 patients with glioblastoma who admitted in Fourth People＇s Hospital of Hengshui City and Harrison International Peace Hospital between January 2011 and June 2013 and received surgical treatment were selected. The patients were randomly divided into observation group （ n = 20） and con- trol group （n = 28 ）. Radiotherapies after operation were given in both two groups. On the basis of concurrent radiotherapy, intravenous infusion of bevaeizumab was given in observation group, and oral temozolomide was given in control group. The changes of relative brain blood volume （rCBV, from dynamic susceptibility contrast magnetic resonance imaging, DSC- MRI） , volume transfer constant （KtranS ,from dynamic contrast enhanced magnetic resonance imaging, DCE-MRI ） , and ma- ximum standard uptake value （SUVMax） ,average standard uptake value （SUV ） and tumor/non tumor （T/NT） （from 18Fluoro-1abeled galactose Arg-Gly-Asp pcptide positron emission tomography, 18 F-Galacto-RGD PET） in different phases （T0, T1 ,T2 ,T3 ） were compared between two groups. The therapeutic effect, median progression free survival （PFS） time and overall survival （OS） time in two groups were analyzed. Results There were no significant differences in the levels of rCBV,K ,SUV SUVmax and T/NT at TO phase between two groups（all P 〉0.05）. As the time of T0→T1→ T2→T3 went on, the levels of rCBV, K^trans, SUV SUVmax and T/NT presented a decreasing trend （ P 〈 0.01, P 〈 O. 05 ） , and they at T1, T2 and T3 phases in observation group were all significantly lower than those in control group （ （all P 〈 0.05 ）. Objec- tive remission rates （ORRs） at 6-, 12- and 24-month of follow-up in observation group were all slightly higher than those in control group, but there were no significant differences in them （ all P

关 键 词：影像生物标志物 贝伐珠单抗 胶质母细胞瘤 生存期 

分 类 号：R739.41[医药卫生—肿瘤]