胶质母细胞瘤肿瘤电场治疗的疗效观察  

Preliminary observation on the efficacy of tumor-treating fields in the treatment of glioblastoma

作　　者：郭晓鹏[1] 邢浩 王裕[1] 马文斌[1] Guo Xiaopeng;Xing Hao;Wang Yu;Ma Wenbin(Department of Neurosurgery,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院神经外科,北京100730

出　　处：《中华神经外科杂志》2024年第6期564-568,共5页Chinese Journal of Neurosurgery

基　　金：中央高水平医院临床科研业务费专项(2022-PUMCH-A-019,2022-PUMCH-B-113)。

摘　　要：目的探讨胶质母细胞瘤(GBM)肿瘤电场治疗(TTFields)的临床疗效及其不良事件(AE)发生情况.方法回顾性分析中国医学科学院北京协和医学院北京协和医院神经外科2019年9月至2023年12月采用TTFields治疗的12例GBM患者的临床资料.其中8例新诊断的GBM患者在术后2~6周开始进行替莫唑胺(TMZ)同步放化疗,续贯TMZ辅助化疗(标准Stupp方案),同时应用TTFields;4例复发性GBM患者术后2~6周开始应用TTFields,其中3例同时应用了贝伐单抗靶向治疗.所有患者每2~4个月随访1次,评估患者的生存情况及与TTFields相关的AE,采用不良事件通用术语评级标准(CTCAE)评估AE的严重程度.结果12例患者应用TTFields的中位总时长为6.5个月(1~47个月),每日治疗的中位时长为23.0 h(8.0~23.5 h).9例患者发生与TTFields相关的AE,其中6例为皮炎,3例为皮肤发热感;CTCAE 1级5例、2级3例、3级1例.12例患者的中位随访时间为14个月(7~51个月),其中8例患者的总随访时间≥12个月.至末次随访,10例生存,2例分别于术后15、33个月死亡.8例患者随访到的无进展生存期(PFS)为2~26个月,其中4例患者的PFS≥12个月.结论对于新诊断及复发性GBM患者,规律及长期应用TTFields仅造成轻、中度的局部皮肤AE,可能会使患者生存获益.Objective To investigate the clinical efficacy and adverse event(AE)of tumor-treating fields(TTFields)therapy in the treatment of glioblastoma(GBM).Methods A retrospective analysis was conducted on the clinical data of 12 patients with GBM treated at the Department of Neurosurgery of Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,from September 2019 to December 2023.Among the 8 newly-diagnosed patients,treatment involved radiotherapy combined with concomitant temozolomide(TMZ)at 2 to 6 weeks after tumor resection,followed by adjuvant TMZ and TTFields.For the 4 recurrent GBM patients,TTFields therapy was applied starting 2 to 6 weeks after redo surgery either as the sole treatment(1 patient)or alongside bevacizumab(3 patients).Regular follow-up was conducted every 2 to4 months,measuring overall survival(OS),progression-free survival(PFS),and AEs.The severity of AEs was evaluated using the Common Terminology Criteria for Adverse Events(CTCAE).Results TTFields were administered for a median daily duration of 23.0 hours(8.0-23.5 hours),with a median total usage duration of 6.5 months(1-47 months).AEs were reported in 9 patients,including 6 cases of dermatitis and 3 cases of heat sensation.In terms of severity,5 were categorized as class-1 AE,3 as class-2 AE,and 1 as class-3 AE.The median follow-up duration was 14 months(range:7-51 months),with 8 patients followed for more than 12 months.At the last follow-up,10 patients were alive,and 2 deceased at 15 and 33 months postoperatively.Eight patients experienced disease progression with a PFS ranging from 2 to 26 months.Four patients had a PFS≥12 months.Conclusion In both newly-diagnosed and recurrent GBMs TTFields therapy causes mild to moderate localized AEs while it could potentially contribute to enhanced patient survival.

关 键 词：胶质母细胞瘤 治疗结果 肿瘤电场治疗 不良事件 

分 类 号：R739.4[医药卫生—肿瘤]