Improving cancer radiotherapy with 2-deoxy-D-glucose: Phase I/II clinical trials on human cerebral gliomas
Improving cancer radiotherapy with 2-deoxy-D-glucose: Phase I/II clinical trials on human cerebral gliomas
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DOI：
10.1016/s0360-3016(96)85017-6
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发表时间：
1996-04-01
影响因子：
7
通讯作者：
Jain, V
中科院分区：
文献类型：
--
作者：
Mohanti, BK;Rath, GK;Jain, V
目的：评价大剂量（5 Gy）放疗联合2-脱氧-d -葡萄糖（2DG）的耐受性、毒性和可行性。2-脱氧-d -葡萄糖是葡萄糖转运和糖酵解的抑制剂，已被证明能不同程度地抑制癌细胞辐射损伤的修复。方法与材料：20例幕上胶质瘤（3/4级）患者，手术后口服2DG （200 mg/kg体重），每周4次，全脑照射（5 Gy）。2周后给予肿瘤部位补充局灶辐射（14 Gy/7分）。通过常规临床评价、x线计算机断层扫描（CT）和磁共振（MR）成像研究急性和晚期放射效应。结果：20例患者均完成治疗，无任何中断。治疗期间各项重要指标均在正常范围内。治疗期间无头痛报告。10例患者在联合治疗（2DG + RT）期间出现轻度至中度恶心和呕吐。在治疗期间未观察到神经系统状况的明显恶化。7例患者在63、43、36、28、27、19和18个月的随访中存活。在这些患者中，临床和磁共振成像研究未显示任何晚期辐射效应。结论：在所有20例患者中观察到良好的耐受性，证明了给予治疗（2DG + 5gy）的可行性。此外，临床和MR研究也显示没有任何脑实质损伤。
Purpose: Evaluation of tolerance, toxicity, and feasibility of combining large fraction (5 Gy) radiotherapy with 2-deoxy-D-glucose (2DG), an inhibitor of glucose transport and glycolysis, which has been shown to differentially inhibit repair of radiation damage in cancer cells.Methods and Materials: Twenty patients with supratentorial glioma (Grade 3/4), following surgery were treated with four weekly fractions of oral 2DG (200 mg/kg body weight) followed by whole brain irradiation (5 Gy). Two weeks later, supplement focal radiation to the tumor site (14 Gy/7 fractions) was given. Routine clinical evaluation, x-ray computerized tomography (CT), and magnetic resonance (MR) imaging were carried out to study the acute and late radiation effects.Results: All the 20 patients completed the treatment without any interruption. The vital parameters were within normal limits during the treatment. None reported headache during the treatment. Mild to moderate nausea and vomiting were observed during the days of combined therapy (2DG + RT) in 10 patients. No significant deterioration of the neurological status was observed during the treatment period. Seven patients were alive at 63, 43, 36, 28, 27, 19, and 18 months of follow-up. In these patients, the clinical and MR imaging studies did not reveal any late radiation effects.Conclusions: Feasibility of administering the treatment (2DG + 5 Gy) is demonstrated by the excellent tolerance observed in all 20 patients. Further, the clinical and MR studies also show the absence of any brain parenchymal damage.