Nagpal Seema, Harsh Griffith, Recht Lawrence
Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA.
Chemother Res Pract. 2011;2011:602812. doi: 10.1155/2011/602812. Epub 2011 Oct 2.
Objective. To quantify the benefits in survival and quality of life in patients receiving bevacizumab (BEV) for recurrent glioblastoma (GBM). Methods. This is a retrospective study of 40 adult patients with recurrent GBM treated between 2005 and 2009 at a single institution. All patients had initial treatment with surgery, radiation, and concurrent temozolomide, then monthly temozolomide. Over 250 charts were screened. Sufficient data was available for 20 patients treated with BEV and 20 patients who did not receive BEV at the time of recurrence. The independent living score (ILS), designed to reward long-term independent survival, was calculated for each patient. Results. The mean ILS was nearly double in the BEV group compared to the No-BEV group (15.0 versus 8.2, P = 0.002, t-test). Two months after initiation of therapy, the median steroid dose dropped by over 90% in patients treated with BEV, but doubled in the NoBEV group. Median survival from the time of recurrence was significantly affected: 10.6 months in the BEV group versus 4.2 months (P < 0.001, log rank survival) in the NoBEV group. Conclusions. BEV increases independent living and lengthens overall survival after GBM recurrence. Reduction in steroid dose may contribute to prolonged independence.
目的。量化接受贝伐单抗（BEV）治疗复发性胶质母细胞瘤（GBM）患者的生存获益及生活质量。方法。这是一项对2005年至2009年在单一机构接受治疗的40例复发性GBM成年患者的回顾性研究。所有患者初始均接受手术、放疗及同步替莫唑胺治疗，随后接受每月一次的替莫唑胺治疗。筛查了超过250份病历。有足够数据的患者为20例接受BEV治疗的患者以及20例复发时未接受BEV治疗的患者。为每位患者计算旨在奖励长期独立生存的独立生活评分（ILS）。结果。与未接受BEV组相比，BEV组的平均ILS几乎翻倍（15.0对8.2，P = 0.002，t检验）。治疗开始两个月后，接受BEV治疗的患者中位类固醇剂量下降超过90%，而未接受BEV组则翻倍。从复发时起的中位生存期受到显著影响：BEV组为10.6个月，未接受BEV组为4.2个月（P < 0.001，对数秩检验生存分析）。结论。BEV可提高GBM复发后的独立生活能力并延长总生存期。类固醇剂量的降低可能有助于延长独立生活时间。
