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使用替拉泊芬钠光动力疗法治疗异柠檬酸脱氢酶野生型诊断为胶质母细胞瘤患者的临床益处:100例回顾性研究

Clinical Benefits of Photodynamic Therapy Using Talaporfin Sodium in Patients With Isocitrate Dehydrogenase -Wildtype Diagnosed Glioblastoma: A Retrospective Study of 100 Cases.

作者信息

Fujimoto Yosuke, Fujita Yuichi, Tanaka Kazuhiro, Nagashima Hiroaki, Yamanishi Shunsuke, Ikeuchi Yusuke, Iwahashi Hirofumi, Sanada Shoji, Muragaki Yoshihiro, Sasayama Takashi

机构信息

Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe , Japan.

Clinical and Translational Research Center, Kobe University Hospital, Kobe , Japan.

出版信息

Neurosurgery. 2025 Jun 1;96(6):1374-1385. doi: 10.1227/neu.0000000000003247. Epub 2024 Nov 4.

Abstract

BACKGROUND AND OBJECTIVES

Photodynamic therapy (PDT) with talaporfin sodium is an intraoperative local therapy administered after the surgical removal of malignant gliomas. However, its clinical efficacy in a large patient population has not been determined. To analyze the clinical outcomes and prognosis in isocitrate dehydrogenase (IDH) -wildtype glioblastoma patients treated with PDT.

METHODS

This retrospective study included patients with newly diagnosed IDH -wildtype glioblastoma treated at Kobe University Hospital between January 2013 and December 2022. PDT involves irradiation of the resection cavity with a 664-nm semiconductor laser after an intravenous infusion of talaporfin sodium. The main outcome measures were the recurrence patterns and survival times, which were compared between the PDT and non-PDT groups. Univariate and multivariate analyses were used to determine the prognostic factors. In addition, adverse events and prognostic factors in the PDT group were analyzed.

RESULTS

A total of 44 and 56 patients were included in the PDT and non-PDT groups, respectively. The local recurrence rate was significantly lower in the PDT group than in the non-PDT group (51.3% vs 83.9%), whereas the distant recurrence and dissemination rates were significantly higher in the PDT group than in the non-PDT group (48.7% vs 16.1%). Two grade 3 adverse events were observed in the PDT group. The median progression-free survival and overall survival times were significantly longer in the PDT group than in the non-PDT group (progression-free survival: 10.8 vs 9.3 months, respectively, and overall survival: 24.6 vs 17.6 months, respectively). Multivariate analysis of the PDT groups revealed that younger age was an independent prognostic factor.

CONCLUSION

PDT with talaporfin sodium provided effective local control with minimal adverse effects. The survival time of the patients treated with PDT was significantly longer than that of the patients who did not receive PDT. Therefore, a randomized controlled clinical trial on PDT is warranted.

摘要

背景与目的

用替莫泊芬钠进行光动力疗法(PDT)是一种在手术切除恶性胶质瘤后进行的术中局部治疗。然而,其在大量患者中的临床疗效尚未确定。分析接受PDT治疗的异柠檬酸脱氢酶(IDH)野生型胶质母细胞瘤患者的临床结局和预后。

方法

这项回顾性研究纳入了2013年1月至2022年12月在神户大学医院接受治疗的新诊断IDH野生型胶质母细胞瘤患者。PDT包括在静脉输注替莫泊芬钠后,用664纳米半导体激光照射切除腔。主要结局指标为复发模式和生存时间,在PDT组和非PDT组之间进行比较。采用单因素和多因素分析来确定预后因素。此外,还分析了PDT组的不良事件和预后因素。

结果

PDT组和非PDT组分别纳入了44例和56例患者。PDT组的局部复发率显著低于非PDT组(51.3%对83.9%),而PDT组的远处复发和播散率显著高于非PDT组(48.7%对16.1%)。PDT组观察到2例3级不良事件。PDT组的无进展生存期和总生存期的中位数显著长于非PDT组(无进展生存期:分别为10.8个月对9.3个月,总生存期:分别为24.6个月对17.6个月)。对PDT组的多因素分析显示,年龄较小是一个独立的预后因素。

结论

替莫泊芬钠PDT提供了有效的局部控制,且不良反应最小。接受PDT治疗的患者的生存时间显著长于未接受PDT治疗的患者。因此,有必要对PDT进行随机对照临床试验。

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