体外化疗药物敏感性试验结果与恶性胶质瘤化疗方案的选择

Result of Chemosensitivity Experiment Guiding the Selection of Chemotherapy Regimen in High Hrade Glioma

目的探讨体外化疗药物敏感性试验对化疗方案选择的意义。方法回顾性分析2005～2010年以来37例WHO分级Ⅲ～Ⅳ级胶质瘤的化疗疗效。病例分为两组,A组为手术切除组织有体外化疗药物敏感性试验结果的,共16例,B组同期无体外药敏试验结果者,共21例。体外化学药物敏感性试验采用TECIA组织块培养法。根据体外化学药物敏感性试验结果结合患者病理分型结果制定化疗方案。结果 37例患者中35例完成4个周期以上化疗。化疗开始半年后评价各组化疗结果。A组有效率(CR+PR)为37.5%,疾病控制率(CR+PR+SD)为68.8%。B组有效率为28.6%,疾病控制率(CR+PR+SD)为52.3%。A组有效率及疾病控制率显著高于B组(P<0.05)。结论体外药物敏感性试验的结果可以为个体化化疗方案的制定提供帮助。根据体外化疗药物敏感性试验的结果结合分子病理的结果制定的个体化化疗方案,可最大程度提高化疗的效果使患者受益。

Objective To carry out chemosensitivity experiment with the TECIA assay aiming at providing theory guidance for clinical chemotherapy regimen among patients with malignant glioma.Methods The clinical result of 35 patients undergone chemotherapy with malignant glioma were analyzed retrospectively.The cohort was divided into two groups.A group included 16 cases who undergone the chemosensitivity experiment results and set down the chemotherapy regimen consulting the result.B group included 21 cases who set down the chemotherapy regimen by the experiments.Results Totally 35 cases completed more than 4 circle chemotherapy.The clinical evaluate time was carried out at 6 months after the chemotherapy began.In A group,6-mon effective rate was 37.5%,6-mon progression-free survival rate was 68.8%.In B group,6-mon effective rate was 28.6%,6-mon progression-free survival rate was 52.3%.（P0.05）.Conclusion Chemosensitivity experiment can avoid using the resistant drugs and provide guidance to improve the clinical chemotherapy effect.And combing the chemosensitivity experiment and the molecule pathology result to set up the chemotherapy regimen might obtain the best effect.