中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2012年
1期
57-60
,共4页
王计伟%陈步东%张春智%孙树鹏%戚贵军%魏厚禄%梁思泉%杨玉山%姚鑫
王計偉%陳步東%張春智%孫樹鵬%慼貴軍%魏厚祿%樑思泉%楊玉山%姚鑫
왕계위%진보동%장춘지%손수붕%척귀군%위후록%량사천%양옥산%요흠
替莫唑胺%卡莫司汀%胶质母细胞瘤%O6-甲基鸟嘌呤-DNA甲基转移酶
替莫唑胺%卡莫司汀%膠質母細胞瘤%O6-甲基鳥嘌呤-DNA甲基轉移酶
체막서알%잡막사정%효질모세포류%O6-갑기조표령-DNA갑기전이매
Temozolomide%BCNU%Glioblastoma%O6-methylguanine-DNA methyltransferase
目的 以卡莫司汀(BCNU)为对照,观察替莫唑胺(TMZ)对胶质母细胞瘤化疗的疗效,并探讨O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)的表达对胶质母细胞瘤预后的影响. 方法 天津市环湖医院神经外科自2004年1月至2009年1月使用化疗药物治疗胶质母细胞瘤患者283例,其中应用TMZ 97例(TMZ组),BCNU 186例(BCNU组),免疫组织化学染色检测手术切除的肿瘤组织中MGMT的表达,对患者进行随访并比较2组患者的生存率、客观有效率和并发症的发生. 结果 TMZ组患者累积生存率高于BCNU组,差异有统计学意义(x2=27.944,P=0.000)；TMZ组、BCNU组患者的客观有效率分别是75.26％(73/97)和45.16％(84/186),差异有统计学意义(x2=24.753,P=0.000);与BCNU组比较,TMZ组白细胞减少症的发生率较低,差异有统计学意义(x2=15.681,P=0.000). 结论 TMZ治疗胶质母细胞瘤疗效较BCNU显著,副作用小,耐受性好,是一种理想的胶质母细胞瘤术后化疗药物.
目的 以卡莫司汀(BCNU)為對照,觀察替莫唑胺(TMZ)對膠質母細胞瘤化療的療效,併探討O6-甲基鳥嘌呤-DNA甲基轉移酶(MGMT)的錶達對膠質母細胞瘤預後的影響. 方法 天津市環湖醫院神經外科自2004年1月至2009年1月使用化療藥物治療膠質母細胞瘤患者283例,其中應用TMZ 97例(TMZ組),BCNU 186例(BCNU組),免疫組織化學染色檢測手術切除的腫瘤組織中MGMT的錶達,對患者進行隨訪併比較2組患者的生存率、客觀有效率和併髮癥的髮生. 結果 TMZ組患者纍積生存率高于BCNU組,差異有統計學意義(x2=27.944,P=0.000)；TMZ組、BCNU組患者的客觀有效率分彆是75.26％(73/97)和45.16％(84/186),差異有統計學意義(x2=24.753,P=0.000);與BCNU組比較,TMZ組白細胞減少癥的髮生率較低,差異有統計學意義(x2=15.681,P=0.000). 結論 TMZ治療膠質母細胞瘤療效較BCNU顯著,副作用小,耐受性好,是一種理想的膠質母細胞瘤術後化療藥物.
목적 이잡막사정(BCNU)위대조,관찰체막서알(TMZ)대효질모세포류화료적료효,병탐토O6-갑기조표령-DNA갑기전이매(MGMT)적표체대효질모세포류예후적영향. 방법 천진시배호의원신경외과자2004년1월지2009년1월사용화료약물치료효질모세포류환자283례,기중응용TMZ 97례(TMZ조),BCNU 186례(BCNU조),면역조직화학염색검측수술절제적종류조직중MGMT적표체,대환자진행수방병비교2조환자적생존솔、객관유효솔화병발증적발생. 결과 TMZ조환자루적생존솔고우BCNU조,차이유통계학의의(x2=27.944,P=0.000)；TMZ조、BCNU조환자적객관유효솔분별시75.26％(73/97)화45.16％(84/186),차이유통계학의의(x2=24.753,P=0.000);여BCNU조비교,TMZ조백세포감소증적발생솔교저,차이유통계학의의(x2=15.681,P=0.000). 결론 TMZ치료효질모세포류료효교BCNU현저,부작용소,내수성호,시일충이상적효질모세포류술후화료약물.
Objective To determine the efficacy of temozolomide (TMZ) in treating patients with glioblastoma using carmustine (BCNU) as control, and examine the effect of O6-methylguanine-DNA methyltransferase (MGMT) expression on the prognosis of patients with glioblastoma. Methods Two hundred and eighty-three patients with pathologically confirmed glioblastoma,admitted to and received treatment without chemotherapeutics in our hospital from January 2004 to January 2009, were enrolled in our study; TMZ was used in 97 patients and BCNU in 186 patients.The glioma tissues were examined for MGMT protein expression by immunohistochemistry.All patients in these 2 groups were performed long-term follow-up for survival time of the patients, tumor response and drug safety. Results In patients of the TMZ treatment group,the median survival time was (19.2±0.6) months,the 2-year survival rate 31％ (30/97),the 5-year survival rate 6.2％ (6/97) and the objective response rate 75.26％ (73/97); while in patients of the BCNU treatment group,the median survival time of was (15.6±0.6) months,the 2-year survival rate 14％ (26/186),the 5-year survival rate 0.5％ (1/186),and objective response rate 45.16％ (84/186); the cumulative survival rate of patients received TMZ treatment was significantly higher than that of patients received BCNU treatment (P＜0.05);the objective response rate between the 2 groups was obviously different (x2=24.753, P=0.000); the incidence of hypoleukocytosis in patients received TMZ treatment was significantly lower than that in patients received BCNU treatment (x2=15.681,P=0.000). Conclusion TMZ shows more efficient oobjective response as compared with BCNU, with less adverse reaction and better tolerability.Therefore,it is an ideal drug of postoperative adjuvant chemotherapy for malignant glioma.
