李庆岗,刘锐,张剑宁.贝伐珠单抗联合替莫唑胺胶囊治疗复发胶质母细胞瘤[J].转化医学杂志,2018,7(3):143-145
贝伐珠单抗联合替莫唑胺胶囊治疗复发胶质母细胞瘤
Bevacizumab in combination with temozolomide capsules for treatment of recurrent glioblastoma
  
DOI:
中文关键词:  复发胶质母细胞瘤  贝伐珠单抗  替莫唑胺胶囊  近期疗效  安全性
英文关键词:Recurrent glioblastoma  Bevacizumab  Temozolomide capsules  Efficacy  Safety
基金项目:国家自然科学基金(81572899)
作者单位
李庆岗 中国人民解放军海军总医院神经外科 
刘锐 中国人民解放军海军总医院神经外科 
张剑宁 中国人民解放军海军总医院神经外科 
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中文摘要:
      目的 研究抗血管生成靶向药贝伐珠单抗联合细胞毒性化疗药替莫唑胺胶囊治疗复发胶质母细胞瘤的临床疗效及安全性。方法 回顾分析海军总医院2014年6月—2015年12月收治的28例复发胶质母细胞瘤患者病例资料,术后均接受贝伐珠单抗联合替莫唑胺方案治疗,第1天至第5天口服替莫唑胺胶囊150-200 mg/m2,28 d为1个周期;静脉滴注贝伐珠单抗5 mg/kg,滴注时间60~90 min,每14天1次,按照实体瘤治疗疗效评价标准评价近期客观疗效,治疗前、治疗后出现病情进展之前进行卡氏评分(Karnofsky performance scale,KPS)和生活质量(quality of life,QOL)评分,药物毒性评价标准采用世界卫生组织抗癌药物急性与亚急性毒性反应分度标准。结果 全部患者均完成至少2周期的化疗治疗,总共完成治疗周期134个,平均4.8个。28例患者中获完全缓解2例(7.14%),部分缓解9例(32.14%),病情稳定12例(42.86%),病情进展5例(17.86%),缓解率为39.28%。中位无进展生存期5.7个月(95%CI=3.8~6.7),中位总生存期7.2个月(95%CI=4.6~7.7)。治疗后KPS评分及QOL评分均较治疗前明显提高,差异具有统计学意义(P<0.05)。主要不良反应包括骨髓抑制19例(67.86%)和胃肠道反应12例(42.86%),多为Ⅰ级(23.40%)和Ⅱ级(14.72%),Ⅲ级较少(2.30%),无Ⅳ级。结论 贝伐珠单抗联合替莫唑胺胶囊治疗复发胶质母细胞瘤临床疗效确切,不良反应可耐受,可作为优选的治疗方法。
英文摘要:
      Objective To assess the efficacy and safety of the treatment using anti-angiogenic targeted drug bevacizumab combined with cytotoxic drug temozolomide (TMZ) capsules in patients with recurrent glioblastoma. Methods In this retrospective study, 28 cases of recurrent glioblastoma were enrolled based on the inclusion criteria from June 2014 to December 2015 in Navy General Hospital. All cases received standard treatment of bevacizumab combined with TMZ after surgery. TMZ was given at 150 to 200 mg/m2 from day 1 to 5 every 4 weeks, and, bevacizumab was administered once every 14 days at 5 mg/kg through continuous intravenous infusion for 60 to 90 minutes. The short-term objective curative effects were evaluated based on response evaluation criteria in solid tumors. The Karnofsky performance scale (KPS) and quality of life (QOL) were scored before the treatment and before disease progressing post-treatment, respectively. Meantime, the toxicity of the treatment was assessed by using Common Toxicity Criteria of WHO. Results A total of 134 cycles and an average of 4.8 cycles of this chemotherapy treatment were administered. All patients were received at least 2 cycles. In these 28 cases, 2 cases (7.14%) were obtained complete remission, 9 cases (32.14%) were partial remission, 12 cases (42.86%) were stable disease, and 5 cases (17.86%) were progression disease. The total remission rate was 39.28%. The efficacy analysis showed a median progression-free survival was 5.7 months (95%CI=3.8—6.7). In terms of overall survival, the median overall survival was 7.2 months (95%CI=4.6—7.7). Improved KPS score and QOL score were observed after treatment, and this difference was significantly (P<0.05). Additionally, some adverse reactions also were observed: bone marrow suppression in 19 cases (67.86%), gastrointestinal response in 12 cases (42.86%). The adverse reactions were classified with gradeⅠ (23.40%), grade Ⅱ (14.72%), grade Ⅲ (2.30%), and grade Ⅳ(0). Conclusion Bevacizumab combined with temozolomide capsules showed definite clinical curative efficacy in recurrent glioblastoma patients with some tolerable adverse reactions. This therapy appeared promising in the treatment of recurrent glioblastoma.
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