Yang Tzu-Ming, Wang Hung-Chen, Lin Yu-Jun, Lin Wei-Che, Lu Cheng-Hsien, Chang Wen-Neng, Chang Hsueh-Wen, Ho Jih-Tsun
Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center and Chang Gung University College of Medicine, Kaohsiung Hsein, Taiwan.
Surg Neurol. 2008 Dec;70 Suppl 1:S1:60-3. doi: 10.1016/j.surneu.2008.08.072.
Malignant gliomas are the most frequent primary brain tumors in adults. In this clinical trial, we compared the therapeutic advantage of radiotherapy followed by temozolomide vs radiotherapy alone for the malignant glioma patients.
In the 4-year retrospective study, 31 patients with histologically confirmed malignant gliomas, in which 10 patients received radiotherapy followed by temozolomide (group A) and 21 patients received radiotherapy alone (group B). The main end point of evaluation and comparison of 2 therapeutic trials was overall survival.
Two patients (6%) underwent biopsy, 19 patients (62%) underwent subtotal resection, and 10 patients (32%) underwent gross total resection. Mean overall survival was 30.44+/-2.41 months for radiotherapy followed by adjuvant temozolomide vs 17.95+/-4.27 months for radiotherapy alone (P=.007). No major adverse effects were observed.
Based on our study, the patients of malignant glioma treated with radiotherapy followed by temozolomide obtained a statistically significant better benefit of survival than those treated with radiotherapy alone. Temozolomide therapy was well tolerated by the patients. The larger series of patients and long-term follow-up of late toxic effects are needed for further confirmation.
恶性胶质瘤是成人中最常见的原发性脑肿瘤。在本临床试验中,我们比较了恶性胶质瘤患者接受放疗后使用替莫唑胺与单纯放疗的治疗优势。
在这项为期4年的回顾性研究中,31例经组织学确诊为恶性胶质瘤的患者,其中10例患者接受放疗后使用替莫唑胺(A组),21例患者仅接受放疗(B组)。两项治疗试验评估和比较的主要终点是总生存期。
2例患者(6%)接受了活检,19例患者(62%)接受了次全切除,10例患者(32%)接受了全切除。放疗后辅助使用替莫唑胺的患者平均总生存期为30.44±2.41个月,而单纯放疗患者为17.95±4.27个月(P = 0.007)。未观察到重大不良反应。
基于我们的研究,恶性胶质瘤患者接受放疗后使用替莫唑胺治疗在生存方面比单纯放疗患者获得了统计学上显著更好的获益。患者对替莫唑胺治疗耐受性良好。需要更多患者系列和对晚期毒性作用的长期随访来进一步证实。