Glass J, Hochberg F H, Gruber M L, Louis D N, Smith D, Rattner B
Department of Neurology, Massachusetts General Hospital, Boston.
J Neurosurg. 1992 May;76(5):741-5. doi: 10.3171/jns.1992.76.5.0741.
Malignant oligodendrogliomas have been shown to be responsive to chemotherapy. The authors administered systemic chemotherapy to seven patients with oligodendroglioma or anaplastic oligodendroglioma, and to 14 with mixed oligodendroglioma-astrocytoma. Fourteen patients underwent chemotherapy before and seven after irradiation. The PCV (procarbazine, methyl-1-(2-chloroethyl)-1-nitrosourea (CCNU), and vincristine) chemotherapy was administered every 6 weeks (42-day cycles) for two to five cycles as follows: CCNU, 110 mg/sq m on Day 1; procarbazine, 60 mg/sq m/day on Days 8 to 21; and vincristine, 1.4 mg/sq m/day on Days 8 and 29. Complete or partial (greater than 50% reduction in tumor mass) responses at 20 to 100+ weeks after treatment were noted in 11 (79%) of the 14 patients treated before irradiation, including two with anaplastic oligodendroglioma and nine with mixed tumors. Complete responses were seen in two patients, one with anaplastic oligodendroglioma and one with a mixed tumor. Partial responses were seen in three of seven patients treated after radiotherapy. Stabilization of tumor growth followed PCV chemotherapy in four patients (two treated before and two after radiotherapy). Tumor growth progressed in two patients during therapy despite an initial response and in two patients despite therapy. The authors conclude that mixed oligodendroglial tumors as well as anaplastic oligodendrogliomas are responsive to PCV chemotherapy.
恶性少突胶质细胞瘤已被证明对化疗有反应。作者对7例少突胶质细胞瘤或间变性少突胶质细胞瘤患者以及14例少突胶质细胞瘤-星形细胞瘤混合型患者进行了全身化疗。14例患者在放疗前接受化疗,7例在放疗后接受化疗。PCV(丙卡巴肼、甲基-1-(2-氯乙基)-1-亚硝基脲(CCNU)和长春新碱)化疗每6周(42天周期)进行2至5个周期,具体如下:CCNU,第1天110mg/平方米;丙卡巴肼,第8至21天60mg/平方米/天;长春新碱,第8天和第29天1.4mg/平方米/天。放疗前接受治疗的14例患者中,11例(79%)在治疗后20至100 +周出现完全或部分(肿瘤肿块缩小大于50%)反应,其中包括2例间变性少突胶质细胞瘤患者和9例混合型肿瘤患者。2例患者出现完全反应,1例为间变性少突胶质细胞瘤,1例为混合型肿瘤。放疗后接受治疗的7例患者中有3例出现部分反应。4例患者(2例放疗前治疗,2例放疗后治疗)在接受PCV化疗后肿瘤生长稳定。2例患者在治疗期间尽管最初有反应但肿瘤生长仍进展,2例患者尽管接受了治疗但肿瘤仍进展。作者得出结论,混合型少突胶质细胞瘤以及间变性少突胶质细胞瘤对PCV化疗有反应。