Recurrent meningioma - Salvage therapy with long-acting somatostatin analogue
Recurrent meningioma - Salvage therapy with long-acting somatostatin analogue
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DOI：
10.1212/01.wnl.0000271382.62776.b7
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发表时间：
2007-09-04
期刊：
影响因子：
9.9
通讯作者：
Fadul, Camilo E.
中科院分区：
文献类型：
--
作者：
Chamberlain, Marc C.;Glantz, Michael J.;Fadul, Camilo E.
背景：生长抑素受体，特别是sst 2A亚型，存在于大多数脑膜瘤。在一些研究中，生长抑素的加入在体外抑制脑膜瘤的生长。有报道称奥曲肽抑制脑膜瘤的生长。目的：一项关于缓释生长抑素的前瞻性先导试验在16例复发性脑膜瘤患者中进行了Sandostatin LAR治疗，主要研究目标是6个月的无进展生存率。（11名女性，5名男性;中位年龄58岁）复发性脑膜瘤患者前瞻性地接受长效生长抑素治疗。患者在既往手术治疗（14/16; 5例完全切除; 7例次全切除; 2例仅活检）、放疗（13/16）和化疗（12/16）后影像学进展。所有患者都确认生长抑素受体在他们的肿瘤中使用In-111-奥曲肽，长效生长抑素激动剂，SPECT scanning.Results：患者接受2至15个周期（中位数4.5）的生长抑素与最小的毒性。观察到4例部分缓解、5例疾病稳定和7例疾病进展模式。缓解持续时间范围为2至20+个月（中位5.0个月）。中位生存期为7.5个月（范围3至20+）。总的无进展生存率为44%（7例）在6 months.Conclusions：在这个小的试验中，复发性脑膜瘤患者过度表达生长抑素受体的奥曲肽血管造影，长效生长抑素（善得定LAR）管理每月一次。31%的患者表现出部分放射学反应，44%的患者在6个月时实现了无进展生存。毒性是最小的，这表明生长抑素类似物可能提供一种新的，相对无毒的替代治疗复发性脑膜瘤。
Background: Somatostatin receptors, especially the sst2A subtype, are present on most meningiomas. The addition of somatostatin inhibits meningioma growth in vitro in some studies. There have been anecdotal reports of octreotide inhibiting growth in meningiomas.Objectives: A prospective pilot trial of sustained-release somatostatin (Sandostatin LAR) in 16 patients with recurrent meningiomas was conducted with a primary study objective of progression-free survival at 6 months.Methods: Sixteen patients ( 11 women, 5 men; median age 58) with recurrent meningioma were treated prospectively with long-acting somatostatin. Patients had progressed radiographically after prior therapy with surgery ( 14/16; complete resection in 5; subtotal in 7; biopsy only in 2), radiotherapy ( 13/16), and chemotherapy ( 12/16). All patients had confirmation of the presence of somatostatin receptors in their tumor using In-111-octreotide, a long-acting somatostatin agonist, SPECT scanning.Results: Patients received 2 to 15 cycles ( median 4.5) of somatostatin with minimal toxicity. Four partial responses, five stable disease, and seven progressive disease patterns were seen. Duration of response ranged from 2 to 20+ months ( median 5.0 months). Median survival was 7.5 months ( range 3 to 20+). The overall progression-free survival was 44% ( seven patients) at 6 months.Conclusions: In this small trial of patients with recurrent meningiomas shown to overexpress somatostatin receptors by octreotide scintigraphy, long-acting somatostatin ( Sandostatin LAR) was administered on a monthly schedule. Thirty-one percent of patients demonstrated a partial radiographic response and 44% achieved progression-free survival at 6 months. Toxicity was minimal, suggesting somatostatin analogues may offer a novel, relatively nontoxic alternative treatment for recurrent meningiomas.