Watanabe K, Kanaya H, Fujiyama Y, Kim P
Division of Neurosurgery, Dokkyo University School of Medicine, Mibu, Tochighi, Japan.
Acta Neurochir (Wien). 2002 Dec;144(12):1265-70; discussion 1270. doi: 10.1007/s00701-002-1023-5.
To study efficacy and safety of chemotherapy using carboplatin (JM-8) and etoposide ("JET" therapy) for the treatment of recurrent malignant glioma, a phase II study was conducted. Tumour control, survival time, and toxicity/side effects were assessed in patients with recurrent malignant glioma which failed to respond to a postoperative combined auxiliary therapy comprising of IFN-beta, ACNU and radiation.
Twenty-eight patients, fourteen with anaplastic astrocytoma (AA) and fourteen with glioblastoma (GB) were included in this study. The JET regimen consists of the intravenous administration of carboplatin (300 mg/m(2)) on day 1 and etoposide (60 mg/m(2)) on day 1 to 5, repeated every 6 weeks.
Following the therapy, we observed partial response (PR) in five (36%) of 14 patients with AA and two (14%) of 14 with GB, and stabilization of the disease (SD) in six (43%) in each group. The mean survival/survival after recurrence was 51 months/25 months in the AA group, and 17/9 in the GB group.
These results compare favorably with the natural course of recurrent malignant glioma. JET shows signs of efficacy in patients with recurrent malignant glioma, and a randomized trial comparing it to standard therapy is warranted.
为研究卡铂(JM - 8)和依托泊苷联合化疗(“JET”疗法)治疗复发性恶性胶质瘤的疗效和安全性,开展了一项II期研究。对接受包含β - 干扰素、阿糖胞苷和放疗的术后联合辅助治疗无效的复发性恶性胶质瘤患者,评估其肿瘤控制情况、生存时间及毒性/副作用。
本研究纳入28例患者,其中14例间变性星形细胞瘤(AA)患者和14例胶质母细胞瘤(GB)患者。JET方案包括第1天静脉注射卡铂(300mg/m²),第1至5天静脉注射依托泊苷(60mg/m²),每6周重复一次。
治疗后,我们观察到14例AA患者中有5例(36%)部分缓解(PR),14例GB患者中有2例(14%)部分缓解,两组各有6例(43%)病情稳定(SD)。AA组复发后的平均生存/生存期为51个月/25个月,GB组为17/9个月。
这些结果优于复发性恶性胶质瘤的自然病程。JET对复发性恶性胶质瘤患者显示出疗效迹象,有必要开展将其与标准疗法进行比较的随机试验。