贝伐珠单抗治疗复发胶质母细胞瘤疗效和预后分析

目的:探讨贝伐珠单抗治疗复发胶质母细胞瘤的疗效及预后因素。方法:回顾性分析2011年12月至2020年7月中山大学肿瘤防治中心接受贝伐珠单抗治疗的81例成人复发胶质母细胞瘤患者的临床资料,评价其疗效和不良反应,以总生存期为预后指标进行单因素和Cox比例风险模型多因素分析。结果:81例患者的客观有效率为62.9%,疾病控制率为80.2%,90.1%的患者生存质量状况(KPS)评分和神经症状有改善。中位无进展生存期(median progression-free survival,mPFS)和中位总生存期(median overall survival,mOS)分别为4.4个月(95%CI:4.0~4.8)和7.8个月(95%CI:6.8~8.8)。单因素分析显示用药时机(首次或≥2次复发时用药)、剂量(5 mg/kg,6~9 mg/kg,10 mg/kg)和是否联合化疗对mOS无影响,多因素分析显示KPS评分和MGMT启动子甲基化状态是影响mOS的独立预后因素。不良事件主要为1~2级。结论:贝伐珠单抗可以改善成人复发胶质母细胞瘤患者的生存质量,治疗耐受性好。KPS评分和MGMT启动子甲基化状态是影响mOS的独立预后因素,贝伐珠单抗在复发后的用药时机、剂量、是否联合化疗对mOS无影响。

CACA guidelines for holistic integrative management of glioma

Glioma of the brain is a kind of tumor originating from neuroglial cells.It is the most common primary intracranial tumor,accounting for~30%of all central nervous system tumors and 80% of malignant brain tumors.Glioma is characterized by high disability and recurrence rates.The disease seriously threatens the life of patients,afects their quality of life,and brings a heavy economic and psychological burden to patients,families,and society.With the progression of molecular genetic testing technology and the completion of various clinical trials,the classifcation scheme for glioma is increasingly well established.Diagnosis and treatment regimens,including traditional and new regimens,are becoming increasingly specialized and standardized.The purpose is to develop a clinical diagnosis and treatment guideline for glioma in the Chinese population suitable for Chinese doctors and the general population based on domestic and international glioma research progress.Thus,domestic practitioners in the feld can obtain current information and provide better service to patients with glioma,promoting the development of domestic clinical medicine and basic research on glioma.