Jackson D, Kinsella T, Rowland J, Wright D, Katz D, Main D, Collins J, Kornblith P, Glatstein E
Radiation Oncology Branch, National Cancer Institute, Bethesda, MD 20892.
Am J Clin Oncol. 1987 Oct;10(5):437-43. doi: 10.1097/00000421-198710000-00014.
Sixty patients with high-grade gliomas (including 50 patients with glioblastoma multiforme) were entered on four sequential Phase I trials combining continuous intravenous infusions of halogenated pyrimidines and high-dose brain irradiation. Patients received two 14-day infusions of bromodeoxyuridine (BUdR) or iododeoxyuridine (IUdR) during the initial wide field and later reduced field radiation treatment (total radiation dose 65-70 Gy). All patients were followed a minimum of 6 months or until death. The actuarial median survival was 13 months for the entire group, with an 18-month survival of 24%. No significant survival differences were observed based on BUdR versus IUdR, 12-h versus 24-h infusion schedule, degree of surgical resection, or sex. Good performance status and age under 50 years were significant favorable prognostic factors. Of interest, the 48 patients who completed planned treatment had a 14-month median survival, with a 30% 18-month survival. These survival observations are at least comparable to other combined modality trials in patients with glioblastoma multiforme. Ongoing and planned clinical trials using the halogenated pyrimidine analogs as radiosensitizers in patients with glioblastoma multiforme are discussed.
60例高级别胶质瘤患者（包括50例多形性胶质母细胞瘤患者）参与了四项连续的I期试验，这些试验将卤代嘧啶的持续静脉输注与大剂量脑部放疗相结合。患者在初始的大野放疗及随后的缩野放疗期间（总放疗剂量65 - 70 Gy）接受了两个为期14天的溴脱氧尿苷（BUdR）或碘脱氧尿苷（IUdR）输注。所有患者至少随访6个月或直至死亡。整个组的精算中位生存期为13个月，18个月生存率为24%。基于BUdR与IUdR、12小时与24小时输注方案、手术切除程度或性别，未观察到显著的生存差异。良好的身体状况和年龄小于50岁是显著的有利预后因素。有趣的是，完成计划治疗的48例患者中位生存期为14个月，18个月生存率为30%。这些生存观察结果至少与多形性胶质母细胞瘤患者的其他综合治疗试验相当。文中还讨论了正在进行和计划开展的将卤代嘧啶类似物用作多形性胶质母细胞瘤患者放射增敏剂的临床试验。
