Concurrent Chemoradiotherapy with Temozolomide Followed by Adjuvant Temozolomide for Newly Diagnosed Glioblastoma Patients: A Retrospective Multicenter Observation Study in Korea.
Concurrent Chemoradiotherapy with Temozolomide Followed by Adjuvant Temozolomide for Newly Diagnosed Glioblastoma Patients: A Retrospective Multicenter Observation Study in Korea.
复制标题
与替莫唑胺的同时进行的化学放射治疗，然后是辅助替莫唑胺，用于新诊断的胶质母细胞瘤患者：韩国的回顾性多中心观察研究。
DOI：
10.4143/crt.2015.473
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发表时间：
2017-01
影响因子：
4.6
通讯作者：
Hong YK
中科院分区：
文献类型：
--
作者：
Kim BS;Seol HJ;Nam DH;Park CK;Kim IH;Kim TM;Kim JH;Cho YH;Yoon SM;Chang JH;Kang SG;Kim EH;Suh CO;Jung TY;Lee KH;Kim CY;Kim IA;Hong CK;Yoo H;Kim JH;Kang SH;Kang MK;Kim EY;Kim SH;Chung DS;Hwang SC;Song JH;Cho SJ;Lee SI;Lee YS;Ahn KJ;Kim SH;Lim DH;Gwak HS;Lee SH;Hong YK
本研究的目的是在韩国样本中调查放疗和辅助替莫唑胺 (TMZ) 联合治疗的可行性和生存获益。回顾性分析了 2006 年 1 月至 2011 年 6 月期间接受 TMZ 同步放化疗 (CCRT) 和辅助 TMZ 的 750 名韩国患者，经组织学证实为多形性胶质母细胞瘤。首次手术后，分别有388例（51.7%）、159例（21.2%）、96例（12.8%）、107例（14.3%）患者实现了大体全切除（GTR）、次全切除（STR）、部分切除（PR）和单纯活检。对 217 名患者的 O6-甲基鸟嘌呤-DNA 甲基转移酶 (MGMT) 的甲基化状态进行了回顾性评价。中位随访期为 16.3 个月，中位总生存期 (OS) 为 17.5 个月。 1 年、3 年和 5 年 OS 的精算生存率分别为 72.1%、21.0% 和 9.0%。中位无进展生存期 (PFS) 为 10.1 个月，精算 1 年、3 年和 5 年 PFS 分别为 42.2%、13.0% 和 7.8%。无论 MGMT 启动子的甲基化状态如何，接受 GTR 的患者均比仅接受 STR、PR 或活检的患者表现出显着更长的 OS 和 PFS。具有甲基化 MGMT 启动子的患者还表现出比具有未甲基化 MGMT 启动子的患者显着更长的 OS 和 PFS。接受超过六个周期辅助 TMZ 的患者比接受六个或更少周期的患者具有更长的 OS 和 PFS。 CCRT 期间有 8.4% 的患者出现 3 级或 4 级血液学毒性，辅助 TMZ 期间有 10.2% 的患者出现 3 级或 4 级血液学毒性。与未接受这种治疗的患者相比，接受 CCRT 并随后辅助 TMZ 治疗的患者具有更好的生存率和可耐受的毒性。
The purpose of this study was to investigate the feasibility and survival benefits of combined treatment with radiotherapy and adjuvant temozolomide (TMZ) in a Korean sample. A total of 750 Korean patients with histologically confirmed glioblastoma multiforme, who received concurrent chemoradiotherapy with TMZ (CCRT) and adjuvant TMZ from January 2006 until June 2011, were analyzed retrospectively. After the first operation, a gross total resection (GTR), subtotal resection (STR), partial resection (PR), biopsy alone were achieved in 388 (51.7%), 159 (21.2%), 96 (12.8%), and 107 (14.3%) patients, respectively. The methylation status of O6-methylguanine-DNA methyltransferase (MGMT) was reviewed retrospectively in 217 patients. The median follow-up period was 16.3 months and the median overall survival (OS) was 17.5 months. The actuarial survival rates at the 1-, 3-, and 5-year OS were 72.1%, 21.0%, and 9.0%, respectively. The median progression-free survival (PFS) was 10.1 months, and the actuarial PFS at 1-, 3-, and 5-year PFS were 42.2%, 13.0%, and 7.8%, respectively. The patients who received GTR showed a significantly longer OS and PFS than those who received STR, PR, or biopsy alone, regardless of the methylation status of the MGMT promoter. Patients with a methylated MGMT promoter also showed a significantly longer OS and PFS than those with an unmethylated MGMT promoter. Patients who received more than six cycles of adjuvant TMZ had a longer OS and PFS than those who received six or fewer cycles. Hematologic toxicity of grade 3 or 4 was observed in 8.4% of patients during the CCRT period and in 10.2% during the adjuvant TMZ period. Patients treated with CCRT followed by adjuvant TMZ had more favorable survival rates and tolerable toxicity than those who did not undergo this treatment.