Neuwelt Alexander J, Nguyen Tam M, Fu Rongwei, Bubalo Joseph, Tyson Rose Marie, Lacy Cynthia, Gahramanov Seymur, Nasseri Morad, Barnes Penelope D, Neuwelt Edward A
Department of Internal Medicine, University of New Mexico, 1 University of NM, Albuquerque, New Mexico 87131, USA.
CNS Oncol. 2014 Jul;3(4):267-73. doi: 10.2217/cns.14.24.
Prophylaxis against Pneumocystis jiroveci pneumonia (PJP) is currently recommended for patients receiving chemoradiation with temozolomide for newly diagnosed glioblastoma multiforme. At our institution, PJP prophylaxis during temozolomide treatment has not been routinely given because of the paucity of supporting data. We investigated the rate of PJP infections in our patients.
PATIENTS & METHODS: We conducted a retrospective chart review of 240 brain tumor patients treated between 1999 and 2012 with temozolomide and no PJP prophylaxis, 127 of which received concurrent chemoradiation.
One in 240 patients (0.4%; 95% CI: 0.01-2.00; median total dose: 7375 mg/m(2); interquartile range: 1300) were diagnosed with PJP.
There was a <1% rate of PJP for brain tumor patients treated with temozolomide until progression without PJP prophylaxis.
目前建议对新诊断的多形性胶质母细胞瘤接受替莫唑胺放化疗的患者进行肺孢子菌肺炎（PJP）预防。在我们机构，由于支持数据匮乏，替莫唑胺治疗期间未常规进行PJP预防。我们调查了我们患者中PJP感染率。
我们对1999年至2012年间接受替莫唑胺治疗且未进行PJP预防的240例脑肿瘤患者进行了回顾性病历审查，其中127例接受了同步放化疗。
240例患者中有1例（0.4%；95%置信区间：0.01 - 2.00；中位总剂量：7375 mg/m²；四分位间距：1300）被诊断为PJP。
在未进行PJP预防的情况下，接受替莫唑胺治疗直至病情进展的脑肿瘤患者中PJP发生率<1%。
