羟基喜树碱与替莫唑胺治疗复发性高级别脑胶质瘤疗效比较

Efficacy comparison of hydroxycamptothecine and temozolomide for recurrent high-grade gliomas

为了探讨羟基喜树碱(HCPT)和替莫唑胺(TMZ)治疗复发性高级别脑胶质瘤的疗效和毒副反应,将47例复发性高级别脑胶质瘤患者随机分为HCPT组23例和TMZ组24例,HCPT组给予HCPT6mg/(m2.d)静脉滴入,连用7d,每28d重复;TMZ组给予TMZ胶囊150mg/(m2.d)口服,连用5d,每28d重复。HCPT组23例患者PR5例,SD9例,PD9例,客观有效率(RR)为21.7%,临床受益率(CBR)为60.9%;TMZ组24例患者PR6例,SD9例,PD8例,RR为26.1%,CBR为65.2%。两组TMZ和CBR比较,差异均无统计学意义,P>0.05。HCPT组中位PFS为3.5个月,OS为7.8个月;TMZ组PFS和OS分别为4.1和8.3个月。两组半年无进展生存率分别为39.1%(9/23)和43.5%(10/23),半年总生存率为60.9%(14/23)和65.2%(15/23),两组比较差异无统计学意义,P>0.05。初步研究结果提示,HCPT单药治疗复发性高级别脑胶质瘤疗效与TMZ相近,是TMZ之外又一个安全有效的高级别脑胶质瘤化疗方案。

The objective of this study was to compare the efficacy and toxicity of hydroxycamptothecine and temozolomide in the treatment of the patients with recurrent high-grade gliomas.Forty-seven patients with recurrent high-grade gliomas were enrolled and randomly divided into HCPT group（n=23） and TMZ group（n=24）.HCPT 6 mg/（m2·d） was given intravenous for 7 days in the HCPT group,repeated every 28 days.The TMZ group received temozolomide capsules 150 mg/（m2·d） orally for 5 days,repeated every 28 days.The HCPT group obtained 5 cases of PR,9 SD and 9 PD,the objective response （RR） was 21.7%,and the clinical benefit rate （CBR） was 60.9%.The TMZ group obtained 6 PR,9 SD and 8 PD cases,RR was 26.1%,CBR was 65.2%.For the efficiency and clinical benefit rate,there was no significant difference between the 5 groups （P0.05）.The median progression-free survival （PFS） of the HCPT group was 3.5 months and median overall survival （OS） was 7.8 months,while in the TMZ group were 4.1 months and 8.3 months respectively,and the progression-free survival rate of six months was 39.1%（9/23） and 43.5%（10/23） and the total survival rate of half-year was 60.9%（14/23） and 65.2%（15/23） respectively（P0.05）.HCPT monotherapy for recurrent high grade gliomas can achieve equivalent efficacy as temozolomide.HCPT is a safe and efficient agent in high-grade glioma chemotherapy besides TMZ.