摘要
目的 :评价含替尼泊甙的联合化疗治疗恶性脑神经胶质瘤的治疗效果和毒副作用 ,探讨有效的辅助化疗方案 ,以期提高恶性脑神经胶质瘤的疗效 ,延长患者的生存期。方法 :不能手术、术后残留或复发的恶性脑神经胶质瘤 2 5例 ,其中大脑半球胶质瘤 15例 ,包括星形细胞瘤Ⅲ级 11例 ,Ⅳ级 4例 ;脑干胶质瘤 8例 ;小脑胶质瘤 2例。采用含替尼泊甙的联合化疗方案 :1)TV方案 :紫杉醇 135mg m2 ,静脉滴入d1;替尼泊甙 2 0 0mg m2 ,分 3天静脉滴入 ,(d1～d3) ,3周后可重复。 2 )MV方案 :司莫司汀 10 0mg m2 ,d1晚顿服 ,替尼泊甙 (用法同前 ) ,6周后重复。第 1周期化疗后常规局部外放疗 ,DT5 0～ 60Gy。结果 :2 5例患者有效 17例 ,总有效率 68 0 % ,其中大脑半球胶质瘤有效率 60 0 % (9 15 ) ,脑干胶质瘤有效率 87.5 % (7 8) ,小脑胶质瘤有效率 5 0 0 % (1 2 )。经χ2 检验 ,两种化疗方案有效率差异无显著性。主要毒性为骨髓抑制 ,特别是中性粒细胞减少 ,其中Ⅲ、Ⅳ度毒性反应 5例 ,占 2 0 0 % ,经对症处理均恢复正常。远期疗效正在观察中。结论 :替尼泊甙加紫杉醇或司莫司汀联合化疗同时放疗治疗恶性脑胶质瘤安全、有效 。
Objectives To evaluate the efficacy and toxicity on curing malignant astrocytic brain tumors by using teniposide combination chemotherapy and to discusses the effective adjuvant chemotherapy regimens in order to prolong the survival time of the patients.Methods Among 25 cases of malignant astrocytic brain tumors that could not be cured with operation or that were recrudescent diseases after operation,there were 15 cases for the astrocytoma of cerebral hemisphere,8 cases for brain stem and 2 cases for cerebellum.The chemotherapy regimens were TV(paclitaxel and teniposide) or MV(semustine and teniposide).The patients also received the routine radiotherapy after the chemotherapy.The efficacy and toxicity were observed in these patients.Results Among 25 cases,17 patients were effective,with 68.0% total effective rate.The effective rates of cerebral hemisphere,brain stem and cerebellum astrocytomas were 60.0%(9/15),87.5%(7/8) and 50.0%(1/2),respectively.The dose-limiting toxicity was the bone marrow suppression,especially granulocytopenia.Conclusion Using TV or MV combination chemotherapy regimen,combined with radiotherapy simultaneously,is a safe and effective way to cure malignant astrocytic brain tumors.
出处
《肿瘤防治杂志》
2003年第2期163-165,共3页
China Journal of Cancer Prevention and Treatment
关键词
脑肿瘤
药物疗法
放射疗法
抗肿瘤药
多剂联用
综合疗法
brain tumor/drug therapy
brain tumor/radiotherapy
anti-cancer drug,combination
combined modality therapy
