CAJ | 학술논문

目的：探讨贝伐单抗联合化疗治疗复发高级别胶质瘤的疗效及安全性。方法回顾性分析2011年3月～2013年12月符合入选标准的11例复发高级别胶质瘤患者，接受贝伐单抗联合替莫唑胺（TMZ）化疗方案治疗。化疗效果按照肿瘤可计算 MRI 增强范围评价疗效，并观察患者治疗前至再次进展之间 KPS、QOL 评分改变。不良反应参照 WHO 抗癌药物急性与亚急性毒性反应分度标准。结果11例患者全部完成2个周期以上的化疗。疗效评价，总体完全缓解（CR）4例，部分缓解（PR）6例，病情稳定（SD）1例，病情进展（PD）0例，缓解率（RR）为90．9％（10／11），DCR 为100％（11／11）；中位 PFS 为5．4个月，中位 OS 为6．5个月。贝伐单抗联合 TMZ 所致不良反应以胃肠道反应（66．3％）、骨髓抑制（43．2％）、肾损伤（39．0％）、高血压（27．3％）常见，本组多为Ⅰ、Ⅱ级（35．93％），很少Ⅲ级（2．60％），无Ⅳ级；治疗后患者 KPS 评分及 QOL评分均较治疗前均有改善（均 P ＜0．05）。结论贝伐单抗联合 TMZ 化疗对复发高级别胶质瘤的治疗有良好的抗肿瘤活性和较高的疾病控制率，安全性较高，是一种可优先选择的治疗方法。
목적：탐토패벌단항연합화료치료복발고급별효질류적료효급안전성。방법회고성분석2011년3월～2013년12월부합입선표준적11례복발고급별효질류환자，접수패벌단항연합체막서알（TMZ）화료방안치료。화료효과안조종류가계산 MRI 증강범위평개료효，병관찰환자치료전지재차진전지간 KPS、QOL 평분개변。불량반응삼조 WHO 항암약물급성여아급성독성반응분도표준。결과11례환자전부완성2개주기이상적화료。료효평개，총체완전완해（CR）4례，부분완해（PR）6례，병정은정（SD）1례，병정진전（PD）0례，완해솔（RR）위90．9％（10／11），DCR 위100％（11／11）；중위 PFS 위5．4개월，중위 OS 위6．5개월。패벌단항연합 TMZ 소치불량반응이위장도반응（66．3％）、골수억제（43．2％）、신손상（39．0％）、고혈압（27．3％）상견，본조다위Ⅰ、Ⅱ급（35．93％），흔소Ⅲ급（2．60％），무Ⅳ급；치료후환자 KPS 평분급 QOL평분균교치료전균유개선（균 P ＜0．05）。결론패벌단항연합 TMZ 화료대복발고급별효질류적치료유량호적항종류활성화교고적질병공제솔，안전성교고，시일충가우선선택적치료방법。
Objective To explore the efficiency and safety of bevacizumab combined with chemotherapy for patients with recurrent high-grade gliomas.Method According to selected standard,11 recurrent high grade glioma patients accepted bevacizumab combined with temozolomide (TMZ)from March 2011 to December 2013 were analyzed retrospectively .The effect of chemotherapy was evaluated according to tumor MRI enhanced image range and KPS and QOL score between treatment and recurrent progression.Side effects were determined according to WHO anti-cancer drugs acute and subacute toxic reaction criterion.Result All of the 11 cases were accepted more than 2 circle chemotherapy,there were 4 cases with complete response(CR),6 cases with partial response (PR),1 case with stable disease(SD)and 0 case with progressive disease(PD).And the objective response rate(RR)was 90.9%,and disease control rate was 100%.The PFS was 5.4 months and OS was 6.5 months.The most commonly adverse events of bevacizumab combinded with TMZ were gastrointestinal adverse reactions (66.3%),bone marrow suppression (43.2%),kidney injury (39%),hypertension (27.3 ),and most were grade Ⅰ-Ⅱ (35.93%)and grade Ⅲ were rare (2.6%),no grade Ⅳ.The KPS and QOL score were improved significantly after treatment compared to them before treatment (all P <0.05).Conclusion Bevacizumab combined with TMZ treatment shown an effective anti-high grade gliom and good control rate and safety.It is a prior alternative treatment method for recurrent high-grade gliomas.