摘要
目的观察应用替莫唑胺(TMZ)治疗手术后脑原发性胶质瘤患者的疗效和安全性。方法选择26例年龄为18～60岁,经病理检查诊断为星形细胞瘤(Ⅱ～Ⅳ级)患者,其中间变性星形细胞瘤(Ⅱ～Ⅲ级)18例,胶质母细胞瘤(Ⅳ级)8例。给予TMZ 150～200mg/(m^2·d),连续空腹口服5 d,28 d为一个疗程(本组患者治疗3～6个疗程)。每一个疗程均随访患者的临床表现,血常规及肝、肾功能,以判断患者能否耐受。TMZ治疗第三及第六个疗程末施行相应的增强CT或MRI检查,与化疗前的影像学资料进行比较,判断肿瘤实体变化情况。结果26例患者中有3例肿瘤完全消失,2例肿瘤体积缩小>50%,5例病情稳定,5例无反应,11例肿瘤体积增大,治疗有效率为10/26,患者6个月生存率为16/26。生存最长者已达20个月。化疗期间患者的不良反应及骨髓毒性较轻微。结论TMZ能有效地延缓肿瘤复发,且安全性和耐受性较好,为一有良好前景的化疗药物。
Objective To observe the curative effect and safety oftemozolimide （TMZ） for primary glioma after operation. Methods Twenty-six patients, aged 18-60 years, pathologically definitely diagnosed as cerebral glioma （grade Ⅱ -Ⅳ）, including anaplastic astrocytoma （ Ⅱ -Ⅲ, n= 18） and glioblastoma （Ⅳ, n=8） not treated with radiotherapy postoperatively. TMZ group were treated with 150-200 mg/m^2 every day for 5 d, 28 d as a treatment course, totally 3-6 courses; physical examination was performed on all patients at each dosing cycle; blood routine, hepatic and renal function test were taken to determine patients＇ tolerability to the drug and the clinical features were also observed; enhanced CT or MRI were performed and compared with the original imaging results before TMZ treatment to determine the changes of solid tumors at the end of 3 and 6 courses. Results Of the 26 cases in TMZ group, tumor completely disappeared in 3 cases, partially regressed in 2 cases, and controlled in 5 cases, did not changed in 5 cases and enlarged in 11 cases; the effective rate was 10/26; 6-month survival rate was 16/26; the longest survival span reached 20 months. During the chemotherapy, adverse effects and myelotoxicity were slight and all of patients were well tolerated. Conclusion TMZ can effectively delay the recurrence of glioma with safety and good tolerability. Therefore, it is a prospective chemotherapeutic agent.
出处
《中华神经医学杂志》
CAS
CSCD
2007年第5期500-502,共3页
Chinese Journal of Neuromedicine
