Ogawa Kazuhiko, Yoshii Yoshihiko, Toita Takafumi, Saito Atsushi, Kakinohana Yasumasa, Iraha Shiro, Sugimoto Koichi, Tsuchida Yukihiro, Tamaki Wakana, Adachi Genki, Hyodo Akio, Murayama Sadayuki
Department of Radiology, University of the Ryukyus, School of Medicine, 207 Uehara, Nishihara-cho, Okinawa, 903-0215, Japan.
Anticancer Res. 2006 May-Jun;26(3B):2457-62.
To evaluate the feasibility, efficacy and toxicity of hyperfractionated radiotherapy and multi-agent chemotherapy, including procarbazine, nimustine (ACNU) and vincristine, in adults with high-grade gliomas.
Radiotherapy was administered using two fractions per day of 1.2 Gy to a total dose of 72 Gy. The chemotherapy consisted of procarbazine (90 mg/m2 orally, days 1 to 14), ACNU (80 mg/m2 intravenously, day 1) and vincristine (0.5 mg/m2 intravenously, days 1 and 8) and was administered during and after radiotherapy, up to a maximum of four courses.
From September 1997 to August 1999, a total of ten patients (five with glioblastoma and five with grade 3 gliomas) were enrolled. All ten patients were able to complete a total dose of 72 Gy hyperfractionated radiotherapy with one course of concurrent chemotherapy. Of eight assessable patients, three (38%) had an objective response, comprising two CR and one PR. The median time to progression was 10.7 months and the median survival time of all patients was 15.0 months. Although grade 4 leukopenia and grade 4 thrombocytopenia occurred in 10% and 10% of all patients, respectively, these were transient and no patients developed neutropenic fever or intracranial hemorrhage. No serious non-hematological or late toxicities occurred.
Hyperfractionated radiotherapy and multi-agent chemotherapy using procarbazine, ACNU and vincristine is safe and well tolerated for high-grade gliomas.
评估超分割放疗联合包括丙卡巴肼、尼莫司汀（ACNU）和长春新碱在内的多药化疗方案，用于治疗成人高级别胶质瘤的可行性、疗效及毒性。
放疗采用每天两次，每次1.2 Gy，总剂量72 Gy。化疗方案为丙卡巴肼（90 mg/m²口服，第1至14天）、ACNU（80 mg/m²静脉注射，第1天）和长春新碱（0.5 mg/m²静脉注射，第1天和第8天），在放疗期间及放疗后进行，最多进行四个疗程。
1997年9月至1999年8月，共纳入10例患者（5例胶质母细胞瘤和5例3级胶质瘤）。所有10例患者均能够完成72 Gy的超分割放疗及一个疗程的同步化疗。在8例可评估患者中，3例（38%）有客观缓解，包括2例完全缓解（CR）和1例部分缓解（PR）。中位疾病进展时间为10.7个月，所有患者的中位生存时间为15.0个月。尽管4级白细胞减少和4级血小板减少分别发生在所有患者的10%中，但这些均为短暂性，且无患者发生中性粒细胞减少性发热或颅内出血。未出现严重的非血液学或晚期毒性反应。
超分割放疗联合使用丙卡巴肼、ACNU和长春新碱的多药化疗方案对高级别胶质瘤是安全且耐受性良好的。
