Newlands E S, O'Reilly S M, Glaser M G, Bower M, Evans H, Brock C, Brampton M H, Colquhoun I, Lewis P, Rice-Edwards J M, Illingworth R D, Richards P G
Department of Medical Oncology, Charing Cross Hospital, London, U.K.
Eur J Cancer. 1996 Dec;32A(13):2236-41. doi: 10.1016/s0959-8049(96)00258-4.
Temozolomide, a new oral cytotoxic agent, was given to 75 patients with malignant gliomas. The schedule used was for the first course 150 mg/m2 per day for 5 days (i.e. total dose 750 mg/m2), escalating, if no significant myelosuppression was noted on day 22, to 200 mg/m2 per day for 5 days (i.e. total dose 1000 mg/m2) for subsequent courses at 4-week intervals. There were 27 patients with primary disease treated with two courses of temozolomide prior to their radiotherapy and 8 (30%) fulfilled the criteria for an objective response. There were 48 patients whose disease recurred after their initial surgery and radiotherapy and 12 (25%) fulfilled the criteria for an objective response. This gave an overall objective response rate of 20 (27%) out of 75 patients. Temozolomide was generally well tolerated, with little subjective toxicity and predictable myelosuppression. However, the responses induced with this schedule were of short duration and had relatively little impact on overall survival. In conclusion, temozolomide given in this schedule has activity against high grade glioma. However, studies evaluating chemotherapy in primary brain tumours should include a quality-of-life/performance status evaluation in addition to CT or MRI scanning assessment.
替莫唑胺是一种新型口服细胞毒性药物，75例恶性胶质瘤患者接受了该药物治疗。用药方案为：第一个疗程每天150mg/m²，持续5天（即总剂量750mg/m²）；如果在第22天未观察到明显的骨髓抑制，则后续疗程剂量递增至每天200mg/m²，持续5天（即总剂量1000mg/m²），疗程间隔为4周。27例原发性疾病患者在放疗前接受了两个疗程的替莫唑胺治疗，其中8例（30%）达到客观缓解标准。48例患者在初次手术和放疗后疾病复发，其中12例（25%）达到客观缓解标准。75例患者中共有20例（27%）达到总体客观缓解率。替莫唑胺耐受性总体良好，主观毒性小，骨髓抑制可预测。然而，该方案诱导的缓解持续时间短，对总生存期的影响相对较小。总之，按此方案给药的替莫唑胺对高级别胶质瘤有活性。然而，评估原发性脑肿瘤化疗的研究除了进行CT或MRI扫描评估外，还应包括生活质量/功能状态评估。
