Fasano Morena, Pirozzi Mario, De Falco Vincenzo, Miceli Chiara Carmen, Farese Stefano, Zotta Alessia, Famiglietti Vincenzo, Vitale Pasquale, Di Giovanni Ilaria, Brancati Christian, Carfora Vincenzo, Solari Domenico, Somma Teresa, Cavallo Luigi Maria, Cappabianca Paolo, Conson Manuel, Pacelli Roberto, Ciardiello Fortunato, Addeo Raffaele
Medical Oncology Unit, Department of Precision Medicine, University of Campania Luigi Vanvitelli, I-80131 Naples, Italy.
Oncology Unit, 'San Giovanni di Dio' Hospital, ASL Napoli 2 Nord, I-80020 Frattamaggiore, Italy.
Oncol Lett. 2024 Jul 2;28(3):418. doi: 10.3892/ol.2024.14551. eCollection 2024 Sep.
The Stupp regimen remains the standard treatment for newly diagnosed glioblastomas, although the prognosis remains poor. Several temozolomide alternative schedules have been studied, with extended adjuvant treatment (>6 cycles of temozolomide) frequently used, although different trials have indicated contrasting results. Survival data of 87 patients who received 6 ('6C' group) or 12 ('12C' group) cycles of temozolomide were collected between 2012 and 2022. A total of 45 patients were included in the 6C group and 42 patients were included in the 12C group. Data on isocitrate dehydrogenase mutation and methylguanine-DNA-methyltransferase (MGMT) promoter methylation status were also collected. The 12C group exhibited statistically significantly improved overall survival [OS; 22.8 vs. 17.5 months; hazard ratio (HR), 0.47; 95% CI, 0.30-0.73; P=0.001] and progression-free survival (15.3 vs. 9 months; HR, 0.39; 95% CI, 0.25-0.62; P=0.001). However, in the subgroup analysis according to MGMT status, OS in the 12C group was significantly superior to OS in the 6C group only in the MGMT unmethylated tumors. The present data suggested that extended adjuvant temozolomide appeared to be more effective than the conventional six cycles.
尽管预后仍然很差，但Stupp方案仍然是新诊断胶质母细胞瘤的标准治疗方法。已经研究了几种替莫唑胺替代方案，经常使用延长辅助治疗（>6个周期的替莫唑胺），尽管不同的试验显示了相反的结果。收集了2012年至2022年期间接受6个周期（“6C”组）或12个周期（“12C”组）替莫唑胺治疗的87例患者的生存数据。6C组共纳入45例患者，12C组共纳入42例患者。还收集了异柠檬酸脱氢酶突变和甲基鸟嘌呤-DNA-甲基转移酶（MGMT）启动子甲基化状态的数据。12C组的总生存期[OS；22.8个月对17.5个月；风险比（HR），0.47；95%置信区间（CI），0.30-0.73；P=0.001]和无进展生存期（15.3个月对9个月；HR，0.39；95%CI，0.25-0.62；P=0.001）在统计学上有显著改善。然而，在根据MGMT状态进行的亚组分析中，仅在MGMT未甲基化肿瘤中，12C组的OS显著优于6C组。目前的数据表明，延长辅助替莫唑胺似乎比传统的六个周期更有效。
