摘要
目的:比较替莫唑胺(TMZ)与福莫司汀(Fotemustine)治疗恶性脑胶质瘤的疗效、生存期及不良反应。方法:56例首次术后脑胶质瘤患者随机分为TMZ组和福莫司汀组各28例,两组患者均给予常规放疗,2Gy/d,5d/w,共持续6-7w,射线总剂量60-66Gy。放疗结束后1周开始化疗。TMZ组在放疗期间每日口服替莫唑胺75mg/m2,放疗结束后4周,继续口服TMZ(150-200)mg/(m2.d),5d/w,每5天为1个疗程,每疗程间隔23天,28天为1个治疗周期,根据患者耐受情况给药4-6个周期。福莫司汀组给予100mg/m2静脉滴注,每周1次连续3周,停药5周,维持期治疗每3周静脉注射1次,共4-6次。结果:TMZ组近期疗效(CR+PR)明显优于福莫司汀组(78.6%vs 50%,P<0.05);TMZ组1、2、3年生存率分别是71.4%(20/28)、39.3%(11/28)、28.6%(8/28),中位生存期22个月。Fotemustine组1、2、3年生存率分别是57.1%(16/28)、32.1%(9/28)、17.9%(5/28),中位生存期12个月。两组比较无显著差异(P>0.05),但有提高生存率的趋势。TMZ组恶心、呕吐及骨髓抑制程度明显低于福莫司汀组(P<0.001),而急慢性脑损伤无显著性差异(P>0.05)。结论:TMZ比福莫司汀可更明显地缩小肿瘤体积,提高近期疗效,有延长患者生存期的趋势,不良作用少,值得临床推广应用。
Objective：To compare the therapeutic effect,survival and safety of malignant gliomas patients treated with temozolomide（TMZ） and fotemustine.Methods： A total of 56 postoperative patients with malignant glioma were randomly divided into two groups： TMZ treatment and Fotemustine treatment group.All patients were performed conventional radiotherapy,2Gy/d,5d/W,6-7weeks as a treatment course,for a total of 60-66Gy.The patients of TMZ group were given daily oral temozolomide 75mg/m2 during radiotherapy.4 weeks after radiotherapy,all of the patients received 4-6 cycles of Temozolomide（150-200）mg/m2.The fotemustine group received fotemustine 100mg/m2 every week during the radiotherapy for 3 weeks.Then followed after a 5-week rest period by fotemustine 100mg/m2 every 3 weeks for 4-6 cycles.Results： The overall response rates（CR＋PR） of the TMZ group and control group separately were 78.6% and 50%,there was significant difference between the two groups（P〈0.05）.The 1,2 and 3 year survival rates of patients in the TMZ group were 71.4%,39.3%,28.6%,and 57.1%,32.1%,17.9% in Fotemustine group.The median recurrent period in the TMZ group were 22 and 12 months in control group,and also with no singnificant difference（P=0.013）.The happening rate of vomitting and myelotoxicity in TMZ group was lower than that in Fotemustine group（P0.001）.But the acute and late toxicity of brain was similar in 2 groups（P〈0.05）.Conclusion： TMZ can improve the local control rate and maybe hopeful to prolong the survival rate with less side effect compared to Fotemustine in patients with malignant gliomas.
出处
《现代肿瘤医学》
CAS
2012年第6期1165-1168,共4页
Journal of Modern Oncology
作者简介
武新虎（1971-），男，甘肃会宁人，硕士，主治医师，主要从事恶性肿瘤放射治疗方向的研究。E—mail：simon—doctor@163．com
沈泽天（1981-），男，江苏泗洪人，硕士，主治医师，主要从事肿瘤的精确放疗及肿瘤放化疗综合治疗方向研究。E—mail：shen—zetian@163．com
