Hildebrand J, Sahmoud T, Mignolet F, Brucher J M, Afra D
Service de Neurologie, Hôpital Erasme, Bruxelles, Belgium.
Neurology. 1994 Aug;44(8):1479-83. doi: 10.1212/wnl.44.8.1479.
We tested adjuvant chemotherapy combining dibromodulcitol (DBD) and bischloroethylnitrosourea (BCNU) given postoperatively to adults with newly diagnosed supratentorial malignant gliomas.
We enrolled 269 patients, 255 of whom were eligible. After surgery, we treated all patients with radiation therapy, using a median dose of 60 Gy given in 30 fractions. After randomization, patients in the chemotherapy group also received (1) six weekly courses, administered during irradiation, of DBD 700 mg/m2 and (2) one to nine (median, four) courses, administered during the first year following radiation therapy, of DBD 1,000 mg/m2 on day 1 and BCNU 150 mg/m2 on day 2, with the course being repeated every 6 weeks.
Patients treated with radiation therapy along with DBD plus BCNU (group 2) had significantly longer survival time (p = 0.044) and time to progression (p = 0.003) than did those treated with radiation therapy alone (group 1). The median survival time was 13.0 months for group 2 and 10.4 months for group 1; the median time to progression was 8.1 months for group 2 and 6.7 months for group 1. The percentage of patients alive at 18 and 24 months was 34% and 21% in group 2 compared with 21% and 12% in group 1.
DBD plus BCNU is an effective adjuvant therapy for malignant glioma.
我们对新诊断的幕上恶性胶质瘤成年患者术后给予二溴卫矛醇（DBD）和双氯乙基亚硝脲（BCNU）联合辅助化疗进行了测试。
我们纳入了269例患者，其中255例符合条件。术后，我们对所有患者进行放射治疗，中位剂量为60 Gy，分30次给予。随机分组后，化疗组患者还接受了：（1）在放疗期间每周1次，共6个疗程的DBD 700 mg/m²；（2）在放疗后的第一年中，给予1至9个（中位为4个）疗程，在第1天给予DBD 1000 mg/m²，第2天给予BCNU 150 mg/m²，每6周重复1个疗程。
接受放疗联合DBD加BCNU治疗的患者（第2组）比单纯接受放疗的患者（第1组）有显著更长的生存时间（p = 0.044）和疾病进展时间（p = 0.003）。第2组的中位生存时间为13.0个月，第1组为10.4个月；第2组的中位疾病进展时间为8.1个月，第1组为6.7个月。第2组在18个月和24个月时存活患者的百分比分别为34%和21%，而第1组分别为21%和12%。
DBD加BCNU是恶性胶质瘤的一种有效辅助治疗方法。
