Temozolomide as initial treatment for adults with low-grade oligodendrogliomas or oligoastrocytomas and correlation with chromosome 1p deletions
Temozolomide as initial treatment for adults with low-grade oligodendrogliomas or oligoastrocytomas and correlation with chromosome 1p deletions
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DOI：
10.1200/jco.2004.10.169
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发表时间：
2004-08-01
影响因子：
45.3
通讯作者：
Delattre, JY
中科院分区：
文献类型：
--
作者：
Hoang-Xuan, K;Capelle, L;Delattre, JY
目的测定低级别少突胶质细胞肿瘤(LGOT)对替莫唑胺(TMZ)的初始治疗缓解率，并评价染色体1p缺失对放射学反应的预测价值。TMZ起始剂量为200 mg/m(2)/d，连用5天，每28天重复一次。临床评价疗效，核磁共振中央回顾，杂合性缺失技术检测染色体1p和19q缺失。结果连续60例患者纳入研究。在分析时，TMZ周期的中位数是11。临床上，51%的患者有改善，特别是那些癫痫未得到控制的患者。客观放射学缓解率为31%(部分缓解率为17%，轻微缓解率为14%)，61%的患者病情稳定，8%的患者病情恶化。肿瘤最大反应的中位时间为12个月(5~20个月)。骨髓抑制是最常见的副作用，8%的患者出现3-4级毒性。染色体1p的丢失与客观的肿瘤反应相关(P<；.004)。结论TMZ耐受性良好，在LGOT中提供了相当高的应答率。染色体1p丢失与X线反应相关，可作为指导LGOT治疗决策的有用指标。(C)2004年，由美国临床肿瘤学会提供。
PurposeTo determine the response rate of low-grade oligodendroglial tumors (LGOT) to temozolomide (TMZ) as initial treatment and to evaluate the predictive value of chromosome 1p deletion on the radiologic response.Patients and MethodsAdult patients with pathologically proven LGOT with progressive disease on magnetic resonance imaging (MRI) were eligible for the study. TMZ was administered at the starting dose of 200 mg/m(2)/d for 5 days, repeated every 28 days. Response was evaluated clinically and by central review of MRIs, Chromosome 1p and 19q deletions were detected by the loss of heterozygosity technique.ResultsSixty consecutive patients were included in the study. At the time of analysis, the median number of TMZ cycles delivered was 11. Clinically, 51% of patients improved, particularly those with uncontrolled epilepsy. The objective radiologic response rate was 31% (17% partial response and 14% minor response), whereas 61% of patients had stable disease and 8% experienced disease progression. The median time to maximum tumor response was 12 months (range, 5 to 20 months). Myelosuppression was the most frequent side effect, with grade 3 to 4 toxicity in 8% of patients. Loss of chromosome 1 p was associated with objective tumor response (P < .004).ConclusionTMZ is well tolerated and provides a substantial rate of response in LGOT. Chromosome 1p loss is correlated with radiographic response and could be a helpful marker for guiding therapeutic decision making in LGOT. (C) 2004 by American Society of Clinical Oncology.