[替莫唑胺用于接受全脑照射治疗的黑色素瘤脑转移患者]

[Temozolomide in patients with melanoma brain metastases treated with whole brain irradiation].

作者信息

Conill Carlos, Fernández-Ibiza Jaime, Malvehy Josep, Puig Susana, Sánchez Marcelo, Castel Teresa

机构信息

Servicio de Oncología Radioterápica. Hospital Clínic de Barcelona. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS). Universidad de Barcelona. Barcelona. Spain.

出版信息

Med Clin (Barc). 2004 Mar 27;122(11):413-5. doi: 10.1016/s0025-7753(04)74256-6.

DOI:10.1016/s0025-7753(04)74256-6

PMID:15066248

Abstract

BACKGROUND AND OBJECTIVE

Whole brain irradiation (WBRT) remains a recommended treatment for patients with brain metastases from malignant melanoma. Temozolomide (TMZ) displays efficacy for the treatment of metastatic melanoma. Our objective was to evaluate the potential benefit of TMZ administered along with WBRT.

PATIENTS AND METHOD

We have conducted a retrospective study in a group of 26 patients comparing WBRT (n = 10) (20 Gy/5 fr) with WBRT+TMZ (n = 16) administered as a single chemotherapeutic agent (200 mg/m2) or in combination with chemoimmunotherapy (150 mg/m2).

RESULTS

The median survival of the total group (n = 26) was 3 months (CI 95%, 2-4 months). The median survival of the WBRT+TMZ group was 6 months (CI 95%, 0-12 months), while the median survival of the WBRT group was 1 month (CI 95%, 1-2 months) (p < 0.0001). The analysis of survival at different time intervals (90, 180 and 270 days) showed a clear benefit for the group treated with WBRT + TMZ (p = 0.016).

CONCLUSIONS

These results suggests a benefit of TMZ added to WBRT in terms of long-term survival for patients with melanoma brain metastases.

摘要

背景与目的

全脑放疗（WBRT）仍是恶性黑色素瘤脑转移患者的推荐治疗方法。替莫唑胺（TMZ）对转移性黑色素瘤的治疗显示出疗效。我们的目的是评估TMZ与WBRT联合使用的潜在益处。

患者与方法

我们对一组26例患者进行了一项回顾性研究，比较了WBRT（n = 10）（20 Gy/5次分割）与作为单一化疗药物（200 mg/m²）或与化学免疫疗法联合使用（150 mg/m²）的WBRT+TMZ（n = 16）。

结果

整个组（n = 26）的中位生存期为3个月（95%置信区间，2 - 4个月）。WBRT+TMZ组的中位生存期为6个月（95%置信区间，0 - 12个月），而WBRT组的中位生存期为1个月（95%置信区间，1 - 2个月）（p < 0.0001）。对不同时间间隔（90、180和270天）的生存分析显示，接受WBRT + TMZ治疗的组有明显益处（p = 0.016）。