卡铂联合依托泊苷化疗治疗复发性脑胶质瘤患者。

Combined carboplatin and etoposide chemotherapy for patients with recurrent glioma.

机构信息

Department of Oncology, Beijing Shijitan Hospital of Capital Medical University, Beijing, China.

出版信息

Ann Palliat Med. 2021 Dec;10(12):12650-12656. doi: 10.21037/apm-21-3382.

DOI:10.21037/apm-21-3382

PMID:35016422

Abstract

BACKGROUND

Currently, there is no consensus on the standard of care for patients with recurrent glioma. This study investigated the efficacy of combined carboplatin and etoposide (CE) treatment in recurrent glioma.

METHODS

A retrospective analysis was performed on adult patients with recurrent glioma who received combination chemotherapy consisting of CE from September 2017 to November 2020 at the Beijing Shijitan Hospital, Capital Medical University, Beijing. The response rate (RR), defined as the complete response (CR) + partial response (PR), and the disease control rate (DCR), defined as CR + PR + stable disease (SD), were analyzed by Chi-square or Fisher's exact test according to different clinical characteristics. Time to progression (TTP) was estimated using Kaplan-Meier plots and the log-rank test was used to compare differences.

RESULTS

A total of 55 patients were assessed and 47 patients were eligible to be enrolled in this study. There was 1 case of CR (2.1%), 3 patients with PR (6.4%), and 18 patients with SD (38.3%). The RR was 8.5% and the DCR was 46.8%. When the patients were stratified by World Health Organization (WHO) grade, the DCR was significantly higher in patients with grade 2 and 3 tumors (83.3% and 50%, respectively) compared to patients with grade 4 tumors (29.6%; P=0.039). For patients with grade 4 gliomas, the median TTP and median overall survival (OS) were 2 [95% confidence interval (CI): 0.988 to 3.012] and 7 (95% CI: 3.626 to 10.374) months, respectively. By comparison, the TTP and OS for patients with grade 2-3 gliomas were 4 (95% CI: 1.947 to 6.053) and 13 (95% CI: 0.000 to 26.47) months, respectively. The 6-month progression free survival (PFS) and 12-month OS were 11.1% and 16.3%, respectively, in patients with grade 4 glioma, compared to 37.9% and 48%, respectively, in patients with grade 2-3 gliomas.

CONCLUSIONS

CE regimen may be effective as a salvage treatment for recurrent glioma. Patients with anaplastic or low-grade glioma may benefit more from such therapy compared to patients with grade 4 tumors.

摘要

背景

目前，对于复发性神经胶质瘤患者，尚无标准的治疗方法。本研究旨在探讨卡铂联合依托泊苷（CE）方案治疗复发性神经胶质瘤的疗效。

方法

回顾性分析 2017 年 9 月至 2020 年 11 月首都医科大学附属北京世纪坛医院采用 CE 方案治疗的复发性神经胶质瘤成年患者的临床资料，方案为卡铂联合依托泊苷。根据不同的临床特征，采用卡方检验或 Fisher 确切概率法分析无进展生存期（PFS）、总生存期（OS）及客观缓解率（ORR）、疾病控制率（DCR）。采用 Kaplan-Meier 法计算中位 PFS 和 OS，Log-rank 检验比较差异。

结果

共评估 55 例患者，47 例患者符合入组条件。完全缓解（CR）1 例（2.1%），部分缓解（PR）3 例（6.4%），疾病稳定（SD）18 例（38.3%）。ORR 为 8.5%，DCR 为 46.8%。按照世界卫生组织（WHO）分级，2~~3 级肿瘤患者的 DCR 明显高于 4 级肿瘤患者（83.3%和 50%，P=0.039）。4 级肿瘤患者的中位 PFS 和 OS 分别为 2 个月（95%CI：0.988~~3.012）和 7 个月（95%CI：3.626~~10.374），2~~3 级肿瘤患者的中位 PFS 和 OS 分别为 4 个月（95%CI：1.947~~6.053）和 13 个月（95%CI：0.000~~26.47）。4 级肿瘤患者的 6 个月无进展生存率（PFS）和 12 个月 OS 分别为 11.1%和 16.3%，2~3 级肿瘤患者的 6 个月 PFS 和 12 个月 OS 分别为 37.9%和 48%。