替莫唑胺剂量密度方案联合顺铂治疗复发高级别胶质瘤效果观察  

Clinical efficacy of cisplatin combined with dose-dense temozolomide in treatment of recurrent high-grade glioma

作　　者：廖加群[1] 黄立敏[1] 易敏[2] 吴坤励 曹雪[1] 雷竹[1] 杨洁[1] LIAO Jiaqun;HUANG Limin;YI Min;WU Kunli;CAO Xue;LEI Zhu;YANG Jie(Guizhou Provincial People＇s Hospital,Guiyang 550002,chin)

机构地区：[1]贵州省人民医院,贵阳550002 [2]山东省军区门诊部

出　　处：《山东医药》2018年第15期9-11,共3页Shandong Medical Journal

基　　金：贵州省卫生厅科学技术基金资助项目(kj2012-1-095)

摘　　要：目的观察替莫唑胺(TMZ)剂量密度方案联合顺铂治疗复发的高级别胶质瘤的临床效果。方法 36例复发高级别胶质瘤(WHOⅢ、IV级)患者,分为A、B、C组各12例。A组采用TMZ剂量密度方案联合顺铂化疗:D1、D2TMZ 75 mg/(m2·d)口服+顺铂40 mg/(m2·d)静滴,D3~21TMZ 75 mg/(m2·d)口服;B组采用TMZ剂量密度方案化疗:D1~21TMZ 75 mg/(m2·d)口服;C组采用TMZ标准方案化疗:D1~5TMZ 150 mg/(m2·d)口服,如患者耐受良好,无明显不良反应,第2周期将TMZ调整为200 mg/(m2·d)。3组均治疗28天为1个治疗周期。采用神经肿瘤评价标准评价3组疗效,计算治疗总有效率(RR)、疾病控制率(DCR),观察治疗过程中不良反应(毒性反应、消化道反应、骨髓抑制、肝肾功能等)发生情况。结果 A、B、C组RR分别为50%、25%、25%,A组RR高于B、C组,P均<0.05;A、B、C组DCR分别为75%、50%、33.3%,A组DCR高于B、C组,P均<0.05。A、B、C组6个月无疾病进展生存(PFS)率分别为66.7%、33.3%、25.0%,A组6个月PFS率高于B、C组,P均<0.05,1年生存率分别为25.0%、16.7%、16.7%,P均>0.05。各组不良反应间差异无统计学意义。结论 TMZ剂量密度方案联合顺铂治疗复发高级别胶质瘤临床效果好,效果优于单独应用TMZ治疗者。Objective To evaluate the clinical efficacy and toxicities of combined use of cisplatin and dose-dense temozolomide（TMZ） in treatment of recurrent high-grade glioma. Methods Thirty-six patients with recurrent high-grade glioma（WHO Ⅲ,IV grade） were randomly divided into three groups： groups A,B,and C,with 12 patients in each group. The patients in the group A received dose-dense TMZ plus cisplatin chemotherapy： TMZ 75 mg/（m2·d） ＋ cisplatin 40 mg/（m2·d） on day 1 and 2,and TMZ 75 mg/（m2·d） on day 3-21; patients in the group B received dose-dense TMZ chemotherapy： TMZ 75 mg/（m2·d） on day 1-21; patients in the group C received standard regimen of TMZ：TMZ150 mg/（m2·d） on day 1-5 for the first cycle and we increased to 200 mg/（m2·d） with the second cycle if there were no heavy toxic effects. The treatment repeated every 28 days for all the three groups. The clinical efficacy was evaluated by the assessment criteria for neural tumors,and the overall clinical response rate（RR） and the disease control rate（DCR） were analyzed. The adverse effects were observed including toxicities,gastrointestinal reaction,myelosuppression,liver function,and renal function,and so on. Results The RR in the group A was significantly higher than that of the other two groups（50% versus 25% of the group B and 25% of the group C,P〈0. 05）. The DCR in the group A was also significantly higher（75% versus 50% of the group B and 33. 3% of the group C,P〈0. 05）. The 6-month PFS rate in the group A was statistically different from that of the other two groups（66. 7% versus 33. 3% of the group B and 25% of the group C,P〈0. 05）. The group A showeda better 1-year survival rate,however,no statistical difference was found among the three groups（25% for the group A,16. 7% for the group B,and 16. 7% for the group C,P〈0. 05）. The adverse effects were well tolerated and there was no statistical significance among the three groups（P〉0. 05）. Conclusion The clinical efficacy of c

关 键 词：替莫唑胺 顺铂 联合用药 胶质瘤 高级别胶质瘤 复发胶质瘤 

分 类 号：R739.41[医药卫生—肿瘤]