Stein M E, Kuten A, Drumea K, Goldsher D, Tzuk-Shina Z
Northern Israel Oncology Center, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute, Haifa, Israel.
J Surg Oncol. 1999 Jul;71(3):167-70. doi: 10.1002/(sici)1096-9098(199907)71:3<167::aid-jso6>3.0.co;2-v.
We conducted a phase II study using carboplatin and etoposide on patients with recurrent malignant glioma to investigate tumor response.
From January 1995 to March 1997, 21 patients with recurrent malignant glioma were treated with a carboplatin (300 mg/m(2), day 1)/etoposide (100 mg/m(2), days 1-3) regimen every 3-4 weeks. The following radiologic parameters were evaluated: tumor size, central lucency, degree of contrast enhancement, and mass effect. No patient had received chemotherapy previously. Dose escalation corresponded to hematologic tolerance and to general and neurologic performance status. Most patients were treated postoperatively with involved field radiotherapy followed by a boost to the tumor area, as defined on the presurgery computed tomography scan or on magnetic resonance imaging. Mean interval to introduction of chemotherapy was 8.8 months (range, 7-36 months). Patients received a mean of four cycles [range, 2-8 cycles].
Only 2 patients showed moderate radiological response, while 12 patients died of progressive disease. Mean time to progression following discontinuation of chemotherapy was 5.8 months (range, 1-11 months). The other patients survived with persistent disease and are being treated palliatively. Toxicity was manageable (1, neutropenic sepsis; 1, thrombocytopenia (45,000/mm(3)); 2, temporarily elevated transaminase level; 2, steroid-induced erosive gastritis).
This phase II regimen proved to be ineffective in recurrent malignant glioma. Further studies incorporating innovative drug regimens and schedules are warranted. J. Surg. Oncol., 1999;71:167-170.
我们开展了一项针对复发性恶性胶质瘤患者的II期研究，使用卡铂和依托泊苷来研究肿瘤反应。
1995年1月至1997年3月，21例复发性恶性胶质瘤患者接受了卡铂（300mg/m²，第1天）/依托泊苷（100mg/m²，第1 - 3天）方案治疗，每3 - 4周重复一次。评估了以下放射学参数：肿瘤大小、中心透亮区、对比增强程度和占位效应。此前所有患者均未接受过化疗。剂量递增依据血液学耐受性以及一般和神经功能状态。大多数患者术后接受累及野放疗，随后对术前计算机断层扫描或磁共振成像所定义的肿瘤区域进行追加放疗。开始化疗的平均间隔时间为8.8个月（范围7 - 36个月）。患者平均接受了4个周期的治疗（范围2 - 8个周期）。
仅2例患者显示出中度放射学反应，而12例患者死于疾病进展。化疗停止后的平均疾病进展时间为5.8个月（范围1 - 11个月）。其他患者带瘤生存，正在接受姑息治疗。毒性反应可控（1例中性粒细胞减少性败血症；1例血小板减少（45,000/mm³）；2例转氨酶水平暂时升高；2例类固醇诱导的糜烂性胃炎）。
该II期方案在复发性恶性胶质瘤中被证明无效。有必要开展进一步研究，纳入创新的药物方案和治疗计划。《外科肿瘤学杂志》，1999年；71:167 - 170。
