Efficacy of temozolomide treatment in patients with high-grade glioma.
Efficacy of temozolomide treatment in patients with high-grade glioma.
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发表时间：
2009-03
影响因子：
2
通讯作者：
S. Oshiro;H. Tsugu;F. Komatsu;T. Ohmura;M. Ohta;S. Sakamoto;T. Fukushima;Tooru Inoue
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文献类型：
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作者：
S. Oshiro;H. Tsugu;F. Komatsu;T. Ohmura;M. Ohta;S. Sakamoto;T. Fukushima;Tooru Inoue
背景许多研究报道了替莫唑胺（TMZ）治疗高级别胶质瘤的临床疗效，但日本人群的信息有限。本研究评估了TMZ治疗的安全性和早期结果，有或没有联合治疗。受试者包括10例高级别胶质瘤患者[多形性胶质母细胞瘤（GBM），n=3，胶质肉瘤（GS），n=1，间变性少突胶质细胞瘤（AO），n=3，间变性混合性少突星形细胞瘤（AOA），n=1，间变性室管膜瘤（AE），n=2]。所有患者均在手术切除后接受常规放疗，伴或不伴辅助化疗。作为二线或三线化疗，患者接受TMZ治疗复发或肿瘤进展。作为联合治疗，在口服TMZ治疗过程中，3例患者局部给予肿瘤坏死因子-α并加入卡铂和依托泊苷。结果10例患者中有4例患者对TMZ治疗达到部分缓解（PR）（客观缓解率为40%），3例患者显示疾病稳定（SD），3例显示疾病进展（PD）。接受联合治疗的患者之一继续显示复发肿瘤的缩小。尽管既往接受过放疗和化疗，但大多数患者仅发生1-2级血液毒性，经保守治疗控制良好。结论TMZ化疗对部分高级别胶质瘤患者有效，无严重毒副反应。评估TMZ的真正疗效需要更大规模的研究，比较其他药物或联合治疗方式之间的长期结果。
BACKGROUND Numerous studies have reported the clinical efficacy of temozolomide (TMZ) treatment for high-grade glioma, but information on Japanese populations has been limited. This study assessed the safety and early outcomes of TMZ treatment, with or without combination therapy. PATIENTS AND METHODS The subjects comprised ten patients with high-grade glioma [glioblastoma multiforme (GBM), n=3, gliosarcoma (GS), n=1, anaplastic oligodendroglioma (AO), n=3, anaplastic mixed oligoastrocytoma (AOA), n=1, and anaplastic ependymoma (AE), n=2]. All the patients were initially treated with conventional radiotherapy following surgical resection with or without adjuvant chemotherapy. As second- or third-line chemotherapy, patients received TMZ for recurrence or tumor progression. As combination therapy, the local administration of tumor necrosis factor-alpha and the addition of carboplatin and etoposide were included for three patients during the course of oral TMZ treatment. RESULTS Partial response (PR) to TMZ therapy was achieved by four out of the ten patients (objective response rate, 40%), while three patients displayed stable disease (SD) and three showed disease progression (PD). One of the patients receiving combination therapy has continued to show shrinkage of the relapsed tumor. Despite prior radio- and chemotherapy, most patients experienced only grade 1-2 hematotoxicity that was well-controlled by conservative therapy. CONCLUSION TMZ chemotherapy is effective for the treatment of high-grade glioma in some patients without serious toxicity. Assessing the true efficacy of TMZ will require a larger study with comparison of long-term outcomes between other agents or combined therapeutic modalities.