Fang Heng-hu, Nie Qing, Kang Jing-bo, Li Fang-ming, Cai Chang-lan
Department of Radiotherapy and Oncology, Navy General Hospital, Beijing, China.
Zhonghua Zhong Liu Za Zhi. 2011 Sep;33(9):707-9.
To study the safety and efficacy of three-dimensional conformal radiotherapy in combination with temozolomide in treatment of patients with diffuse brainstem glioma.
Twelve patients with MRI-confirmed diffuse brainstem glioma received 54 Gy three-dimensional conformal radiotherapy for 6 weeks with 1.8 Gy per fraction, 5 times per week. All of the patients were given daily oral temozolomide 75 mg/m(2) during radiotherapy. Four weeks after radiotherapy, all of the patients received 6 cycles of temozolomide, each cycle lasted 5 days with 28 days interval between each two cycles. 150 mg/m(2) of temozolomide was given for the first cycle for five days, followed by 200 mg/m(2) of the drug for the rest of the cycles if no significant drug-related toxicities were observed. Magnetic resonance imaging and laboratory tests were performed to evaluate the efficacy and adverse reactions.
In the 12 patients, CR was 1 case (8.3%), PR 6 cases (50.0%), SD 2 cases (16.7%), and PD 3 cases (25.0%). The overall clinical benefit rate was 75.0%. Progression-free survival rate was 75.0% (9/12) at 6 months and 50.0% (6/12) at 1 year. The one-year overall survival rate was 75.0%. There were no severe temozolomide-related toxicities.
Concurrent temozolomide with three-dimensional conformal radiotherapy and followed by 6 cycles of temozolomide chemotherapy for diffuse brainstem gliomas have a better clinical efficacy, good tolerance and with no severe toxicities.
研究三维适形放疗联合替莫唑胺治疗弥漫性脑干胶质瘤患者的安全性和疗效。
12例经磁共振成像（MRI）确诊的弥漫性脑干胶质瘤患者接受三维适形放疗，总剂量54 Gy，分6周进行，每次1.8 Gy，每周5次。所有患者在放疗期间每日口服替莫唑胺75 mg/m²。放疗4周后，所有患者接受6个周期的替莫唑胺治疗，每个周期持续5天，两个周期之间间隔28天。第1周期替莫唑胺剂量为150 mg/m²，连用5天，若未观察到明显的药物相关毒性，则其余周期剂量为200 mg/m²。通过磁共振成像和实验室检查评估疗效及不良反应。
12例患者中，完全缓解（CR）1例（8.3%），部分缓解（PR）6例（50.0%），疾病稳定（SD）2例（16.7%），疾病进展（PD）3例（25.0%）。总临床受益率为75.0%。6个月时无进展生存率为75.0%（9/12），1年时为50.0%（6/12）。1年总生存率为75.0%。未出现与替莫唑胺相关的严重毒性反应。
对于弥漫性脑干胶质瘤，三维适形放疗联合替莫唑胺同步治疗，随后进行6个周期的替莫唑胺化疗，具有较好的临床疗效、良好的耐受性且无严重毒性。
