抗血管生成靶向药物治疗恶性胶质瘤的临床研究

Clinical research on anti-angiogenetic targeting agents for malignant glioma treatment

目的探讨抗血管生成靶向药物贝伐单克隆抗体联合细胞毒性化疗药物替莫唑胺或拓扑替康治疗恶性胶质瘤的效果。方法4例复发或残留恶性胶质瘤患者,3例行贝伐单克隆抗体(10mg/kg)联合替莫唑胺[50mg/(m2·d)]治疗(分别治疗14、15和6个周期);1例给予贝伐单克隆抗体(10mg/kg)联合拓扑替康[1.20mg/(m2·d)]治疗3个周期。结果3例复发性胶质母细胞瘤患者,2例完全缓解,1例肿瘤进展但疗效尚满意;1例残留间变性星形细胞瘤患者部分缓解。化疗期间,4例患者均出现Ⅰ度骨髓抑制现象,1例血清转氨酶水平轻度升高,2例发生轻度鼻出血。结论贝伐单克隆抗体联合替莫唑胺或拓扑替康治疗复发或残留恶性胶质瘤患者临床疗效满意,可作为重要的辅助治疗方法。

Objective To investigate the curative effect of bevacizumab combined with temozolomide or topotecan in malignant glioma. Methods Four patients with recurrent or residual malignant glioma were studied. Three cases were given bevacizumab （10 mg/kg） combined with temozolomide [50 mg/（m^2·d）] for 14, 15 and 6 therapeutic cycles, respectively, while the other patient received bevacizumab （10 mg/kg） combined with topotecan [1.20 mg/（m^2·d）] for 3 therapeutic cycles. Results In 3 cases of recurrent glioblastoma, 2 cases achieved complete remission, while one case advanced continuously but the therapeutic effect was still satisfied, and the other patient with residual anaplastic astrocytoma was partly remitted. During chemotherapy all patients occurred Ⅰ degree of myelosuppression. In one case the serum transaminase levels were higher than normal. Two cases had nasal hyporrhea. Conclusion The curative effect of bevacizumab combined with temozolomide or topotecan is rather satisfied in the treatment of recurrent or residual malignant glioma. The combination therapy can be used as an important accessory treatment for malignant glioma.