Chamberlain M C, Kormanik P A
University of California, San Diego, La Jolla 92093-8421, USA.
J Clin Oncol. 1997 Dec;15(12):3427-32. doi: 10.1200/JCO.1997.15.12.3427.
A prospective phase II study of paclitaxel was performed in adult patients with recurrent hemispheric oligodendrogliomas.
Twenty adult patients (14 men and six women), ages 18 to 52 years (median, 40.5), with recurrent supratentorial hemispheric oligodendrogliomas were treated. All patients had previously been treated with surgery, involved-field radiotherapy (median dose, 55 Gy; range 54 to 55 Gy) and nitrosourea-based (procarbazine, lomustine [CCNU], and vincristine [PCV-3 regimen]) chemotherapy (median number of cycles, five; range, four to six). Fourteen patients were treated adjuvantly with radiotherapy and nitrosourea-based chemotherapy; six were treated at recurrence following initial gross total resection with reoperation (subtotal resection in all), radiotherapy, and nitrosourea-based chemotherapy. Paclitaxel was administered intravenously at a dose of 175 mg/m2 every 3 to 4 weeks with neurologic and neuroradiographic evaluation every 8 weeks.
A median of three cycles of paclitaxel (range, two to 10) were administered. All patients were assessable. Toxicity included partial alopecia (12 patients), thrombocytopenia (six), neutropenia (three), and anemia (one). One patient developed neutropenic fever without bacteriologic documentation and four required transfusion of blood products (RBCs, n = 2; platelet, n = 2). No treatment-related deaths occurred. Ten patients (50%) demonstrated either a neuroradiographic partial response (n = 3) or stable disease (n = 7), with a median response and stable disease duration of 10 months (range, 5 to 14).
Paclitaxel demonstrated modest efficacy with minimal toxicity in this pretreated cohort of adult patients with recurrent hemispheric oligodendrogliomas.
对成年复发性半球少突胶质细胞瘤患者进行了一项紫杉醇的前瞻性II期研究。
对20例成年患者（14例男性和6例女性）进行了治疗，年龄在18至52岁之间（中位数为40.5岁），患有复发性幕上半球少突胶质细胞瘤。所有患者此前均接受过手术、局部野放疗（中位剂量55 Gy；范围54至55 Gy）以及基于亚硝基脲的化疗（丙卡巴肼、洛莫司汀[CCNU]和长春新碱[PCV - 3方案]）（中位周期数为5个；范围4至6个）。14例患者接受了放疗和基于亚硝基脲的辅助化疗；6例在初次大体全切后复发，接受了再次手术（均为次全切除）、放疗和基于亚硝基脲的化疗。紫杉醇以175 mg/m²的剂量每3至4周静脉给药一次，每8周进行神经学和神经影像学评估。
紫杉醇的给药中位周期数为3个（范围2至10个）。所有患者均可评估。毒性包括部分脱发（12例患者）、血小板减少（6例）、中性粒细胞减少（3例）和贫血（1例）。1例患者出现无细菌学记录的中性粒细胞减少性发热，4例患者需要输注血液制品（红细胞，n = 2；血小板，n = 2）。未发生与治疗相关的死亡。10例患者（50%）表现出神经影像学部分缓解（n = 3）或疾病稳定（n = 7），缓解和疾病稳定的中位持续时间为10个月（范围5至14个月）。
在这个成年复发性半球少突胶质细胞瘤的预处理队列中，紫杉醇显示出适度疗效且毒性最小。
