替尼泊苷动脉化疗联合贝伐珠单抗在复发高级别脑胶质瘤的临床回顾性研究

A clinical retrospective study of teniposide intra-arterial chemotherapy combined with bevacizumab in treatment of recurrent high-grade glioma

摘要:

目的 探索替尼泊苷超选动脉化疗联合贝伐珠单抗在复发高级别脑胶质瘤治疗的临床疗效和安全性。方法 79例复发高级别脑胶质瘤患者按治疗方法的不同，分为试验组37例（替尼泊苷动脉化疗联合贝伐珠单抗治疗）和对照组42例（贝伐珠单抗单药治疗），比较两组患者脑胶质瘤维持治疗后的客观缓解率、疾病控制率及不良反应率，评估O⁶-甲基鸟嘌呤-DNA甲基转移酶基因启动子甲基化状态对两组患者疾病控制率的影响。结果 试验组和对照组的客观缓解率分别为43.2%和21.4%（P=0.038），疾病控制率分别为78.4%和54.8%（P=0.027）。试验组在轻度消化道反应（P=0.044）、头痛（P=0.044）及白细胞减少（P=0.026）的不良反应发生率高于对照组。试验组年龄小于60岁人群的疾病控制率较对照组明显增加（P<0.05）。结论 在高级别脑胶质瘤维持治疗中，替尼泊苷超选动脉化疗联合贝伐珠单抗的疗效优于贝伐珠单抗单药治疗，值得临床进一步推广。

Abstract:

Objective To investigate the efficacy and safety of teniposide superselective intra-arterial chemotherapy combined with bevacizumab in the treatment of recurrent high-grade glioma.Methods According to the treatment method，79 patients with recurrent high-grade glioma were divided into experimental group with 37 patients （teniposide intra-arterial chemotherapy combined with bevacizumab） and control group with 42 patients （bevacizumab monotherapy）. The two groups were compared in terms of objective response rate，disease control rate，and the incidence rate of adverse reactions，and the impact of the gene promoter methylation status of O⁶-methylguanine-DNA methytransferase on disease control rate was analyzed.Results The objective response rate was 43.2% in the experimental group and 21.4% in the control group（P=0.038），and the disease control rate was 78.4% in the experimental group and 54.8% in the control group（P=0.027）. Compared with the control group，the experimental group had significantly higher incidence rates of the adverse reactions such as mild gastrointestinal reactions（P=0.044），headache（P=0.044），and leucopenia（P=0.026）. Compared with the control group，the experimental group had a significantly higher disease control rate in the population aged <60 years（P<0.05）.Conclusion Teniposide superselective intra-arterial chemotherapy combined with bevacizumab has better efficacy than bevacizumab monotherapy in the treatment of recurrent high-grade glioma and thus holds promise for further clinical application.