长周期替莫唑胺治疗高级别胶质瘤生存期观察

Survival analysis of patients with high-grade glioma treated by long-term therapy with temozolomide

目的评价长周期替莫唑胺（temozolomide,TMZ）化疗（TMZ〉6周期）对高级别胶质瘤患者的安全性和可行性。方法 2008-2015年本院收治的93例高级别胶质瘤患者,按服用TMZ周期数分为TMZ〉6周期组和TMZ 6周期组。两组年龄、性别、病理级别、手术方式等差异无统计学意义（P〉0.05）。评估两组患者无进展生存期（progression free survival,PFS）和中位生存时间（overall survival,OS）的差异。采用Kaplan-Meier法绘制两组的生存曲线。结果 TMZ〉6周期组的PFS和OS分别为29（10～54）个月和39（13～65）个月,6周期组分别为21（6～50）个月和28（6～48）个月,TMZ〉6周期组的PFS和OS明显延长（PFS：P=0.035;OS：P=0.011）;服用TMZ出现的3级及以上不良反应主要是血小板减少（6.45%）及白细胞减少症（9.68%）,但主要出现在服用TMZ 6个周期内,增加服药周期并未明显增加药物不良反应。结论长周期（〉6周期）TMZ化疗较6周期TMZ化疗延长高级别胶质瘤患者生存期,且未明显增加药物的不良反应。

Objective To evaluate the safety,feasibility of long-term temozolomide chemotherapy（TMZ6 cycles） on highgrade glioma patients.Methods Ninety-three high-grade glioma patients in Chinese PLA General Hospital from 2008 to 2015 were divided into TMZ6 cycles group and TMZ 6 cycles group.There were no significant differences in age,gender,pathological grade,surgical method between two groups（P〈0.05）.The differences between two groups in progression free survival（PFS） and overall survival（OS） were evaluated,and the survival curves of two groups were depicted by Kaplan-Meier method.Results Both OS and PFS of patients in TMZ6 cycles group were significantly longer than those of patients in TMZ 6 cycles group（PFS：29 months vs 21 months,P=0.035;OS：39 months vs 28 months,P=0.011）,and the most common seen adverse reactions of grade 3 or above in patients after taking TMZ were thrombocytopenias（6.45%） and leucopenia（9.68%）,which all occurred within 6 cycles.No obvious adverse reaction was observed in prolonged TMZ cycles.Conclusion Long-term treatment with temozolomide（TMZ6 cycles） is efficacious in prolonging PFS and OS for high grade glioma patients without additional side-effects.