ACNU-based chemotherapy for recurrent glioma in the temozolomide era
ACNU-based chemotherapy for recurrent glioma in the temozolomide era
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DOI：
10.1007/s11060-008-9728-9
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发表时间：
2009-03-01
影响因子：
3.9
通讯作者：
Eisele, Guenter
中科院分区：
文献类型：
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作者：
Happold, Caroline;Roth, Patrick;Eisele, Guenter
由于替莫唑胺已成为新诊断胶质母细胞瘤患者的首选治疗，因此尚未定义复发性胶质母细胞瘤患者的标准治疗。这重新引起了人们对使用亚硝基脲为基础的方案治疗进行性或复发性疾病患者的兴趣。最常用的方案是卡莫司汀（BCNU）单药治疗或洛莫司汀（CCNU）联合丙卡巴肼和长春新碱（PCV）。在这里，我们报告了我们的机构经验，尼莫司汀（ACNU）单独（n = 14）或与其他药物（n = 18）在32例胶质母细胞瘤患者治疗以前与替莫唑胺。没有完全答复和两份部分答复。6个月时的无进展生存率（PFS）为20%，12个月时的生存率为26%。在50%的患者中观察到III级或IV级血液学毒性，并导致13%的患者中断治疗。非血液学毒性为中度至重度，导致9%的患者中断治疗。因此，在这个替莫唑胺预治疗的患者队列中，ACNU未能诱导复发性胶质母细胞瘤的疾病基本稳定，但引起了显著的血液毒性。本研究不推荐ACNU作为替莫唑胺预治疗复发性胶质母细胞瘤患者的首选治疗。
No standard of care for patients with recurrent glioblastoma has been defined since temozolomide has become the treatment of choice for patients with newly diagnosed glioblastoma. This has renewed interest in the use of nitrosourea-based regimens for patients with progressive or recurrent disease. The most commonly used regimens are carmustine (BCNU) monotherapy or lomustine (CCNU) combined with procarbazine and vincristine (PCV). Here we report our institutional experience with nimustine (ACNU) alone (n = 14) or in combination with other agents (n = 18) in 32 patients with glioblastoma treated previously with temozolomide. There were no complete and two partial responses. The progression-free survival (PFS) rate at 6 months was 20% and the survival rate at 12 months 26%. Grade III or IV hematological toxicity was observed in 50% of all patients and led to interruption of treatment in 13% of patients. Non-hematological toxicity was moderate to severe and led to interruption of treatment in 9% of patients. Thus, in this cohort of patients pretreated with temozolomide, ACNU failed to induce a substantial stabilization of disease in recurrent glioblastoma, but caused a notable hematotoxicity. This study does not commend ACNU as a therapy of first choice for patients with recurrent glioblastomas pretreated with temozolomide.