Gwak Ho-Shin, Yee Gi Taek, Park Chul-Kee, Kim Jin Wook, Hong Yong-Kil, Kang Seok-Gu, Kim Jeong Hoon, Seol Ho Jun, Jung Tae-Young, Chang Jong Hee, Yoo Heon, Hwang Jeong-Hyun, Kim Se-Hyuk, Park Bong Jin, Hwang Sun-Chul, Kim Min Su, Kim Seon-Hwan, Kim Eun-Young, Kim Ealmaan, Kim Hae Yu, Ko Young-Cho, Yun Hwan Jung, Youn Ji Hye, Kim Juyoung, Lee Byeongil, Lee Seung Hoon
Registration Group, Korean Society for Neuro-Oncology, Korea.
Pharmaceutical Benefit Department, Health Insurance Review and Assessment Service, Korea.
J Korean Neurosurg Soc. 2013 Dec;54(6):489-95. doi: 10.3340/jkns.2013.54.6.489. Epub 2013 Dec 31.
To evaluate the efficacy of temozolomide (TMZ) chemotherapy for recurrent anaplastic oligodendroglioma (AO) and anaplastic oligoastrocytoma (AOA).
A multi-center retrospective trial enrolled seventy-two patients with histologically proven AO/AOA who underwent TMZ chemotherapy for their recurrent tumors from 2006 to 2010. TMZ was administered orally (150 to 200 mg/m(2)/day) for 5 days per 28 days until unacceptable toxicity occurred or tumor progression was observed.
TMZ chemotherapy cycles administered was median 5.3 (range, 1-41). The objective response rate was 24% including 8 cases (11%) of complete response and another 23 patients (32%) were remained as stable disease. Severe side effects (≥grade 3) occurred only in 9 patients (13%). Progression-free survival (PFS) of all patients was a median 8.0 months (95% confidence interval, 6.0-10.0). The time to recurrence of a year or after was a favorable prognostic factor for PFS (p<0.05). Overall survival (OS) was apparently differed by the patient's histology, as AOA patients survived a median OS of 18.0 months while AO patients did not reach median OS at median follow-up of 11.5 months (range 2.7-65 months). Good performance status of Eastern Cooperative Oncology Group 0 and 1 showed prolonged OS (p<0.01).
For recurrent AO/AOA after surgery followed by radiation therapy, TMZ could be recommended as a salvage therapy at the estimated efficacy equal to procarbazine, lomustine, and vincristine (PCV) chemotherapy at first relapse. For patients previously treated with PCV, TMZ is a favorable therapeutic option as 2nd line salvage chemotherapy with an acceptable toxicity rate.
评估替莫唑胺（TMZ）化疗对复发性间变性少突胶质细胞瘤（AO）和间变性少突星形细胞瘤（AOA）的疗效。
一项多中心回顾性试验纳入了72例经组织学证实为AO/AOA且在2006年至2010年期间因复发性肿瘤接受TMZ化疗的患者。TMZ口服给药（150至200mg/m²/天），每28天给药5天，直至出现不可接受的毒性或观察到肿瘤进展。
TMZ化疗周期的中位数为5.3（范围1 - 41）。客观缓解率为24%，包括8例（11%）完全缓解，另有23例患者（32%）病情稳定。严重副作用（≥3级）仅发生在9例患者（13%）中。所有患者的无进展生存期（PFS）中位数为8.0个月（95%置信区间，6.0 - 10.0）。复发时间为一年或一年后是PFS的有利预后因素（p<0.05）。总生存期（OS）因患者的组织学类型明显不同，AOA患者的OS中位数为18.0个月，而AO患者在中位随访11.5个月（范围2.7 - 65个月）时未达到OS中位数。东部肿瘤协作组（ECOG）评分为0和1的良好身体状况显示OS延长（p<0.01）。
对于术后接受放疗后的复发性AO/AOA，TMZ可作为挽救治疗推荐，其估计疗效与首次复发时的丙卡巴肼、洛莫司汀和长春新碱（PCV）化疗相当。对于先前接受过PCV治疗的患者，TMZ作为二线挽救化疗是一种有利的治疗选择，毒性率可接受。
