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对于年龄 > 75 岁的胶质母细胞瘤患者,采用低分割放疗联合替莫唑胺治疗后,贝伐珠单抗挽救治疗的疗效。

Treatment outcomes of hypofractionated radiotherapy combined with temozolomide followed by bevacizumab salvage therapy in glioblastoma patients aged > 75 years.

机构信息

Department of Neurosurgery, Faculty of Medicine, Yamagata University, 2-2 Iida-Nishi, Yamagata, Yamagata, 990-9585, Japan.

Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata, Yamagata, Japan.

出版信息

Int J Clin Oncol. 2018 Oct;23(5):820-825. doi: 10.1007/s10147-018-1298-z. Epub 2018 May 23.

Abstract

BACKGROUND

The optimal treatment for elderly patients with glioblastoma has not been established.

METHODS

We retrospectively analyzed the safety and efficacy of hypofractionated radiotherapy (45 Gy/15 fr) combined with temozolomide (TMZ) followed by bevacizumab (BEV) salvage treatment in 18 glioblastoma patients aged > 75 years.

RESULTS

All of the patients received safe hypofractionated radiotherapy and concomitant TMZ (75 mg/m), and 14 of 18 patients received maintenance TMZ. We administered BEV to 17 of 18 patients because their Karnofsky Performance Status scores declined and/or recurrence was detected. During the follow-up period (median duration: 17.5 months, range 3-33 months), 12 patients died of their disease. While the median progression-free survival period was 2.5 months, the median overall survival period was 20 months. Adverse events (National Cancer Institute Common Terminology Criteria for Adverse Events grade 3 or 4) occurred in 5 patients.

CONCLUSION

Hypofractionated radiotherapy combined with TMZ and BEV salvage treatment was found to be safe and effective in glioblastoma patients aged > 75 years.

摘要

背景

老年胶质母细胞瘤患者的最佳治疗方法尚未确定。

方法

我们回顾性分析了 18 例年龄>75 岁的胶质母细胞瘤患者接受低分割放疗(45 Gy/15 次)联合替莫唑胺(TMZ)治疗,以及贝伐珠单抗(BEV)挽救治疗的安全性和疗效。

结果

所有患者均接受了安全的低分割放疗和 TMZ (75mg/m2)同步治疗,18 例患者中有 14 例接受了维持 TMZ 治疗。我们对 18 例患者中的 17 例使用了 BEV,因为他们的 Karnofsky 表现状态评分下降和/或发现复发。在随访期间(中位持续时间:17.5 个月,范围 3-33 个月),12 例患者死于疾病。虽然中位无进展生存期为 2.5 个月,但中位总生存期为 20 个月。5 例患者发生不良事件(美国国立癌症研究所不良事件通用术语标准 3 或 4 级)。

结论

低分割放疗联合 TMZ 和 BEV 挽救治疗在年龄>75 岁的胶质母细胞瘤患者中是安全有效的。

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