贝伐单抗联合替莫唑胺治疗复发恶性脑胶质瘤的疗效及安全分析

Activity and safety of bevacizumab plus temozolomide for recurrent malignant gliomas

目的：探讨贝伐单抗联合替莫唑胺治疗复发恶性脑胶质瘤的临床疗效和安全性。方法选择既往接受过Stupp标准方案治疗的复发恶性脑胶质瘤患者共25例，均予以贝发珠单抗（ BEV，10 mG/KG，静脉滴注，每2周1次）联合替莫唑胺（ TMZ，200 mG/m^2，口服，连用5 d，28 d为1个周期）治疗，观察其临床疗效、不良反应。结果25例患者中有8例（32%）部分缓解，13例（52%）稳定，4例（16%）进展，疾病控制率为84%，6个月PFS率及中位PFS分别为44%和5个月，中位OS为8个月。主要不良反应包括胃肠道反应、骨髓抑制、高血压，Ⅲ～Ⅳ级不良反应发生率为20%，无治疗相关性死亡。结论贝伐单抗联合替莫唑胺治疗复发恶性脑胶质瘤疗效确切，安全性高，可作为复发恶性脑胶质瘤化疗的优先选择方案。

objective To investigate the activity and safety of bevacizumab combined With temo-zolomide combination in the treatment of recurrent malignant gliomas. Methods A total of 25 recurrent malignant gliomas patients Who Were previously treated With temozolomide plus radiotherapy Were enrolled in this study,all patients Were treated With bevacizumab（ BEV,10 mg/Kg,q2W）plus temozolomide （ TMZ,200 mg/m^2 ,5 d/28 d）,the clinical curative effects and complications Were observed after thera-py. Results Eight patients（32%）had partial response,thirtheen patients（52%）had stable diseases, and four patients（ 16%）had progressive diseases. The disease control rate Was 84%. The six month PFS rate and median PFS Were determined as 44% and 5 months respectively. Mediam oS Was 8 months. The major tocxities Were gastrointestinal reaction,myelosuppression and hypertension,the occurrence rate of grade Ⅲ～Ⅳ toxicity Was 20%,there Was no treatment-related death. Conclusions Bevacizumab com-bined With temozolomide has good curative effect and high safety in the treatment of recurrent malignant gli-omas,Which can be used as a preferred option in recurrence malignant glioma chemotherapy.