替莫唑胺治疗新诊断的高级别胶质瘤（III级和IV级）期间及之后的肿瘤体积变化

Tumor Volume Changes During and After Temozolomide Treatment for Newly Diagnosed Higher-Grade Glioma (III and IV).

作者信息

Wang Hung-Chen, Lin Yu-Tsai, Lin Wei-Che, Ho Ren-Wen, Lin Yu-Jun, Tsai Nai-Wen, Ho Jih-Tsun, Lu Cheng-Hsien

机构信息

Department of Neurosurgery, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Department of Otolaryngology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.

出版信息

World Neurosurg. 2018 Jun;114:e766-e774. doi: 10.1016/j.wneu.2018.03.078. Epub 2018 Mar 16.

DOI:10.1016/j.wneu.2018.03.078

PMID:29555610

Abstract

BACKGROUND

A standard post-concomitant radiochemotherapy involving adjuvant temozolomide (TMZ) was stopped after 6 cycles for high-grade gliomas (HGG). Several studies demonstrated that prolonged TMZ treatment increased survival for these patients.

METHODS

This retrospective study aimed to compare changes in tumor volume during and after adjuvant TMZ treatment and overall survival (OS).

RESULTS

There were 90 patients were administered adjuvant TMZ treatment. Comparing average tumor volume changes during TMZ treatment and after TMZ was stopped, a significant decrease in tumor volume was observed during TMZ treatment in the total patient population, the anaplastic astrocytoma (AA) group, and the glioblastoma multiforme (GBM) group (P ≤ 0.001, P = 0.042, and P = 0.005, respectively). Median overall survival was 78.4 weeks, which was significant regarding the surgical tumor resection rate (r = 0.241; P = 0.04) and total TMZ treatment cycles (r = 0.631; P ≤ 0.001).

CONCLUSIONS

During adjuvant TMZ treatment, tumor volume decreased significantly (P = 0.042, and P = 0.005, respectively) in patients with GBM and AA. Prolonged TMZ administration improved OS, without increased toxicity.

摘要

背景

针对高级别胶质瘤（HGG）的标准同步放化疗联合辅助替莫唑胺（TMZ）方案在6个周期后停止。多项研究表明，延长TMZ治疗可提高这些患者的生存率。

方法

本回顾性研究旨在比较辅助TMZ治疗期间及之后肿瘤体积的变化以及总生存期（OS）。

结果

共有90例患者接受了辅助TMZ治疗。比较TMZ治疗期间及停止TMZ治疗后肿瘤体积的平均变化，在总患者群体、间变性星形细胞瘤（AA）组和多形性胶质母细胞瘤（GBM）组中，TMZ治疗期间肿瘤体积均显著减小（分别为P≤0.001、P = 0.042和P = 0.005）。中位总生存期为78.4周，这在手术肿瘤切除率（r = 0.241；P = 0.04）和TMZ总治疗周期方面具有显著性（r = 0.631；P≤0.001）。