长周期替莫唑胺治疗高级别胶质瘤生存期观察

Survival analysis of patients with high-grade glioma treated by long-term therapy with temozolomide

  • 摘要: 目的 评价长周期替莫唑胺(temozolomide,TMZ)化疗(TMZ> 6周期)对高级别胶质瘤患者的安全性和可行性。 方法 2008-2015年本院收治的93例高级别胶质瘤患者,按服用TMZ周期数分为TMZ > 6周期组和TMZ 6周期组。两组年龄、性别、病理级别、手术方式等差异无统计学意义(P > 0.05)。评估两组患者无进展生存期(progression free survival,PFS)和中位生存时间(overall survival,OS)的差异。采用Kaplan-Meier法绘制两组的生存曲线。 结果 TMZ > 6周期组的PFS和OS分别为29(10~54)个月和39(13~65)个月,6周期组分别为21(6~50)个月和28(6~48)个月,TMZ > 6周期组的PFS和OS明显延长(PFS: P=0.035 ;OS: P=0.011);服用TMZ出现的3级及以上不良反应主要是血小板减少(6.45%)及白细胞减少症(9.68%),但主要出现在服用TMZ 6个周期内,增加服药周期并未明显增加药物不良反应。 结论 长周期(>6周期) TMZ化疗较6周期TMZ化疗延长高级别胶质瘤患者生存期,且未明显增加药物的不良反应。

     

    Abstract: Objective To evaluate the safety, feasibility of long-term temozolomide chemotherapy (TMZ> 6 cycles) on high grade glioma patients. Methods Ninety-three high-grade glioma patients in Chinese PLA General Hospital from 2008 to 2015 were divided into TMZ> 6 cycles group and TMZ 6 cycles group. There were no significant differences in age, gender, pathologica grade, surgical method between two groups (P> 0.05). The differences between two groups in progression free survival (PFS) and overall survival (OS) were evaluated, and the survival curves of two groups were depicted by Kaplan-Meier method. Results Both OS and PFS of patients in TMZ> 6 cycles group were significantly longer than those of patients in TMZ 6 cycles group (PFS: 29 months vs 21 months, P=0.035; OS: 39 months vs 28 months, P=0.011), and the most common seen adverse reactions of grade 3 o above in patients after taking TMZ were thrombocytopenias (6.45%) and leucopenia (9.68%), which all occurred within 6 cycles. No obvious adverse reaction was observed in prolonged TMZ cycles. Conclusion Long-term treatment with temozolomide (TMZ> 6 cycles) is efficacious in prolonging PFS and OS for high grade glioma patients without additional side-effects.

     

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