Somlyai Gábor, Kovács Beáta Zsuzsanna, Papp András, Somlyai Ildikó
HYD LLC for Cancer Research and Drug Development, Villányi út 97, 1118 Budapest, Hungary.
Department of Public Health, Albert Szent-Györgyi Medical School, University of Szeged, 6720 Szeged, Hungary.
Biomedicines. 2023 Jul 13;11(7):1989. doi: 10.3390/biomedicines11071989.
Glioblastoma multiforme (GBM) and malignant gliomas are the most common primary malignant brain tumors. Temozolomide (TMZ) chemotherapy plus radiation therapy (RT), admi-mistered after debulking surgery, increased the median survival time (MST) from 12.1 months with RT alone merely to 14.6 months, respectively. In this study, the actions of deuterium-depleted water (DDW) on the survival of GBM patients who also received conventional therapies was investigated. Without changing the conventional treatment, the daily fluid intake of the patients was wholly replaced with DDW in 1.5-2 L per day volume to reduce the D concentration in their bodies. The primary endpoint was the MST. The 55 patients involved in this study, who received conventional treatment and consumed DDW, showed a longer MST (30 months) compared to the historical control (12.1-14.6 months). There was a massive difference between the two genders in the calculated MST values; it was 25 months in the male subgroup (n = 33) and 42 months in the female subgroup (n = 22), respectively. The MST was 27 months without TMZ treatment (38 patients) and 42 months in the TMZ-treated group (17 patients), respectively. For the selected 31 patients, who consumed DDW in the correct way in addition to their conventional treatments, their MST was calculated as 30 months. Within this group, the 20 subjects who had relapsed before DDW treatment had 30 months of MST, but in those 10 subjects who were in remission when DDW treatment started, their MST was 47 months. In the subgroup of patients who began their DDW treatment parallel with radiotherapy, their MST was again 47 months, and it was 25 months when their DDW treatment was started at 8 weeks or later after the completion of radiotherapy. Altogether, these survival times were substantially prolonged compared to the prospective clinical data of patients with primary GBM. Consequently, if conventional therapies are supplemented with D depletion, better survival can be achieved in the advanced stage of GBM than with the known targeted or combination therapies. Application of DDW is recommended in all stages of the disease before surgery and in parallel with radiotherapy, and repeated DDW courses are advised when remission has been achieved.
多形性胶质母细胞瘤(GBM)和恶性胶质瘤是最常见的原发性恶性脑肿瘤。替莫唑胺(TMZ)化疗加放射治疗(RT),在肿瘤切除术后进行,将中位生存时间(MST)仅从单纯放疗的12.1个月分别提高到了14.6个月。在本研究中,研究了去氘水(DDW)对同样接受传统治疗的GBM患者生存情况的影响。在不改变传统治疗的情况下,将患者的日常液体摄入量全部替换为每天1.5 - 2升的DDW,以降低其体内的氘浓度。主要终点是MST。本研究纳入的55例接受传统治疗并饮用DDW的患者,其MST(30个月)比历史对照(12.1 - 14.6个月)更长。计算得到的MST值在两性之间存在巨大差异;男性亚组(n = 33)为25个月,女性亚组(n = 22)为42个月。未接受TMZ治疗的患者(38例)MST为27个月,接受TMZ治疗的组(17例)MST为42个月。对于选定的31例除接受传统治疗外还正确饮用DDW的患者,其MST计算为30个月。在该组中,20例在饮用DDW治疗前复发的患者MST为30个月,但在DDW治疗开始时处于缓解期的10例患者中,其MST为47个月。在与放疗同时开始饮用DDW治疗的患者亚组中,其MST再次为47个月,而在放疗完成后8周或更晚开始饮用DDW治疗时,MST为25个月。总体而言,与原发性GBM患者的前瞻性临床数据相比,这些生存时间显著延长。因此,如果在传统治疗的基础上补充氘消耗,在GBM晚期可实现比已知的靶向治疗或联合治疗更好的生存效果。建议在疾病的所有阶段,术前以及与放疗同时应用DDW,并且在实现缓解后建议重复进行DDW疗程。