摘要
目的:前瞻性观察尼妥珠单抗联合再程放疗治疗复发性高分级胶质瘤患者的疗效和不良反应。方法:2008年10月—2011年3月,10例复发性高分级胶质瘤患者接受再程常规分割放射治疗。首程放疗与再程放疗间隔时间为7～42个月,中位时间为20个月。再程放疗剂量为40～51Gy(18～27fx),26～40d;中位剂量为48Gy(24fx),35d。放疗期间,每周静脉滴注尼妥珠单抗1次,共3～6次。记录不良反应和近期疗效,计算总生存率和无进展生存率。结果:急性反应主要是Ⅰ～Ⅱ级头痛、消化系统反应和神经功能障碍加重,经对症治疗可明显缓解,未发现Ⅲ级以上急性不良反应。有3例患者发生放射性脑坏死。10例患者中,部分缓解3例,疾病稳定6例,疾病进展1例;KPS评分提高4例、不变4例、下降2例。中位疾病进展时间为6.5个月,6个月和1年无进展生存率分别为60%和20%;中位生存时间为11.5个月,6个月和1年总生存率分别为80%和50%。结论:尼妥珠单抗联合再程放疗治疗复发性高分级胶质瘤患者有效而安全,对长期疗效还有待进一步随访。
Objective： To prospectively evaluate the side-effect and outcomes of nimotuzumab combined with reirradiation in patients with recurrent high-grade glioma. Methods： Ten patients with recurrent high-grade glioma recruited between October 2008 and March 2011 were reirradiated with conventional fractionation. The interval between initial radiation therapy and reirradiation was 7-42 months （the median time was 20 months）. The irradiation dose was 40-51 Gy （18-27 fx） for 26-40 d [the median dose was 48 Gy （24 fx ） for 35d]. Intravenous injection of nimotuzumab was used weekly during radiation therapy for 3-6 weeks. The toxicities and short responses were recorded. The overall survival and the progression-free survival were calculated. Results： The acute adverse reactions were gradesI-H headache, digestive system side effects, and aggravation of the neurologic dysfunction, but they were all relieved after symptomatic treatment. The toxicity of more than grade 1I was not observed. The radiation-induced brain necrosis was found in three patients. Of the 10 patients, 3 had partial response, 6 had stable disease, and 1 had progressive disease. The Karnofsky performance status score was increased, unchanged and decreased in 4, 4 and 2 patients, respectively. The median time to progression was 6.5 months. The 6-month and 1-year progression-free survival rates were 60% and 20%, respectively. The median overall survival was 11.5 months. The 6-month and 1-year overall survival rates were 80% and 50%, respectively. Conclusion： The preliminary results demonstrate that nimotuzumab combined with reirradiation for recurrent high-grade glioma appears to be effective and safe. The further follow-up is required to determine the long-term outcomes.
出处
《肿瘤》
CAS
CSCD
北大核心
2012年第7期551-554,共4页
Tumor
