Department of Oncology, University Hospital Zurich, Switzerland.
Acta Oncol. 2011 Jun;50(5):630-5. doi: 10.3109/0284186X.2011.572913. Epub 2011 Apr 18.
Patients with recurrent high-grade glioma (HGG) have a poor prognosis and there is no defined standard of care. High levels of vascular endothelial growth factor (VEGF) expressed in HGG make the anti-VEGF monoclonal antibody bevacizumab (BEV) of particular interest.
In an ongoing registry data were collected from patients who have received BEV for the treatment of recurrent HGG. The primary objective was the identification of any clinical benefit as assessed by change in Karnofsky Performance Score (KPS), decreased steroid use and duration of treatment.
Two hundred and twenty-five patients with HGG were included (176 glioblastoma; 49 anaplastic glioma; median age 52 years). KPS improved in 10% of patients and remained stable in 68%. Steroids were stopped in 37.6% of patients. Median duration of treatment was 5.5 months; 19.1% of patients were treated for more than 12 months. Median overall survival from beginning of BEV treatment was 8.5 months. At the time of analysis, 169 patients (75.1%) had died and 56 patients (24.9%) were alive. Only 21 patients (9.3%) discontinued treatment due to toxicity.
Our data reveal valuable palliation with preservation of KPS and an option for steroid withdrawal in patients treated with BEV, supporting the role of this therapy in late-stage disease.
复发性高级别胶质瘤（HGG）患者预后较差，目前尚无明确的治疗标准。HGG 中表达的高水平血管内皮生长因子（VEGF）使得抗 VEGF 单克隆抗体贝伐单抗（BEV）成为研究热点。
在一项正在进行的登记研究中，收集了接受 BEV 治疗复发性 HGG 的患者的数据。主要目的是通过卡氏功能状态评分（KPS）的变化、类固醇使用减少和治疗持续时间来确定任何临床获益。
共纳入 225 例 HGG 患者（176 例胶质母细胞瘤；49 例间变性星形细胞瘤；中位年龄 52 岁）。10%的患者 KPS 改善，68%的患者稳定。37.6%的患者停用了类固醇。治疗的中位持续时间为 5.5 个月；19.1%的患者治疗时间超过 12 个月。从开始接受 BEV 治疗到中位总生存期为 8.5 个月。在分析时，169 例患者（75.1%）死亡，56 例患者（24.9%）存活。只有 21 例患者（9.3%）因毒性而停止治疗。
我们的数据显示，BEV 治疗可提供有价值的姑息治疗，保留 KPS，并使类固醇停药成为可能，支持该治疗方法在晚期疾病中的作用。
