VM26联合MeCCNU在人脑低级别胶质瘤治疗中应用的
初步探讨
曹广辉;谭卫国;冯鸣;申昊;王君祥;黄煜伦;周幽心
【期刊名称】《临床神经外科杂志》 【年(卷),期】2011(008)001
【摘要】Objective To explore the efficiency of VM26 combined with MeCCNU therapy for the low-grade gliomas of MCMT-positive after tumor resection and radiotherapy. Methods The clinical data of 22 patients with MCMT-positive who underwent total removal of tumors with enhanced MRI imaging showing no residual tumors from Jan 2005 to Oct 2008 in our department were analyzed retrospectively. Of 22 patients . 10 were diffuse astrocytomas; 3 were oligodendrogliomas;5 were are mixed oligo-astrocytomas and 4 ependymomas. These patients received three-dimensional conformal radiotherapy 2 -4 weeks after surgery with radiation and exposure dose being ( 50～ 55 ) Gy( 6 ～ 7 )weeks. 2 weeks after the end of radiotherapy , these patients underwent VM26 comhined with MeCCNU therapy ( VM26 : 50mg/m2/day , intravenous dripping for 3 days , repeated after 8 weeks for 3 cycles.MeCCNU: 50mg/m2/day, taken orally for 3 days, repeated after 8 weeks for 4 cycles) with MRI scanning regularly. Results Of 22 MCMT-positive grade Ⅱ gliomas,6 cases were positive for both TopoⅡα and Pgp,10 and 2 were only positive for TopoⅡα and Pgp,
respectively; and 4 were negative for both TopoⅡα and Pgp. The following up from 2 t0 5 years showed tumors recurred in 6 cases with average time of recurrence being 16. 6 months ,CT or MRI imaging showed no tumor recurrence in 13 ,3 underwent the second surgery due to MRI imaging showing possible tumor recurrence 2 vears after prior surgery. Pathological examination reported suspected recurring tumor was necrotic tissue. In these 22 patients , one vear survival rate of one vear was 100％ and two vears was 88.9％ . Conclusions VM26 combined with MeCCNU chemotherapy is able to efficaciously inhibit the growth of gliomas ,with little side-effects.safety. It's an therapeutic method for patients with low-grade MGMT-positive gliomas aftert tumor resection and radiotherapy.%目的 探讨人脑胶质瘤手术切除和放疗后O6-甲基鸟嘌呤DNA甲基转移酶(MGMT)阳性的低级别胶质瘤患者应用替尼泊甙(VM26)+甲基环亚硝脲(MeCCNU)联合治疗疗效.方法 总结分析我科2005.01-2008.10年收治的资料较完整、全切肿瘤22例,MRI增强扫描未见肿瘤征像,术后病理证实免疫组化MGMT阳性的弥漫性星形细胞瘤10例,少突胶质瘤3例,少突星形细胞瘤5例,室管膜瘤4例.术后2～4周后行三维适形放射治疗,剂量为50～55 Gy/6～7周.放疗后2周选择VM26为50mg/m2/d,连续3 d静脉滴注,8周后重复,进行3个周期;Me-CCNU为50 mg/m2/d,连续3d 口服,8周后重复,持续4个周期.并定期复查MRI.结果 MGMT、TopoⅡα及Pgp染色,TopoⅡα及PgP同时阳性者6例,仅TopoⅡα阳性者10例,仅PgP阳性者2例.TopoⅡα及PgP同时阴性者4例.随访2～5年,22例中有6例肿
瘤复发,平均复发时间 16.6月,13例至今头颅CT和/或MRI检查未见肿瘤复发,另有3例2年后MRI怀疑复发而手术,病理为坏死组织.22例患者1年生存率为100%,2年生存率为88.9%.结论 脑胶质瘤手术切除和放疗后MGMT阳性的低级别胶质瘤患者应用VM26联合MeCCNU治疗方案能有效地控制肿瘤,并且毒副作用小,安全可靠,是有效的治疗方法. 【总页数】3页(10-12) 【关键词】胶质瘤;化学治疗
【作者】曹广辉;谭卫国;冯鸣;申昊;王君祥;黄煜伦;周幽心
【作者单位】215000,苏州大学附属第一医院神经外科;215000,苏州大学附属第一医院神经外科;215000,苏州大学附属第一医院神经外科;215000,苏州大学附属第一医院神经外科;215000,苏州大学附属第一医院神经外科;215000,苏州大学附属第一医院神经外科;215000,苏州大学附属第一医院神经外科 【正文语种】中文 【中图分类】R739.4 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_journal-clinical-neurosurgery_thesis/0201237332450.html 【相关文献】
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VM26联合MeCCNU在人脑低级别胶质瘤治疗中应用的初步探讨
