背景:本病例系列描述了超选择性动脉内(IA)脑输注替尼泊苷治疗神经胶质瘤患者的安全性和有效性,为高级别胶质瘤的治疗提供新的思路和方法。
方法:12例先前接受标准治疗的神经胶质瘤患者接受超选择性IA脑内输注替尼泊苷治疗。患者接受至少两个周期的治疗(一个周期:150毫克/次,使用1天,每隔28天重复一次)。患者对肿瘤部位进行个体化治疗。在超选择性动脉输注期间绕过眼动脉。
结果:治疗前后生化指标和Karnofsky表现状况(KPS)评分无明显差异,无明显不良事件发生(P>0.05)。在最近的回应评估(2023年8月)中,2例(8%)患者出现完全缓解(16.7%),四个有部分反应(33.3%),4人病情稳定(33.3%),和两个显示进行性疾病(16.7%)。总有效率和疾病控制率分别为50.0%和83.3%,分别。此外,我们描述了两名患者的详细治疗过程.1号病例(复发肿瘤)和2号病例(原发肿瘤)接受了6个和3个周期的替尼泊苷输注,分别。治疗后,患者肿瘤明显缩小,无明显不良反应。
结论:这个小系列表明,替尼泊苷超选择性IA脑内输注在恶性神经胶质瘤的多模式治疗中可能是一种安全有效的治疗方法,值得在更大的前瞻性研究中进一步研究。
BACKGROUND: This
case series describes the safety and efficacy of superselective intra-arterial (IA) cerebral infusion of teniposide for the treatment of patients with glioma, to provide new ideas and methods for the treatment of high grade gliomas.
METHODS: 12 patients with glioma who were previously treated with standard therapy were treated with superselective IA cerebral infusion of teniposide. Patients received at least two cycles of treatment (one cycle: 150 mg/time, used for 1 day, repeated at 28 day intervals) after blood-brain barrier disruption. Patients received individualized treatment on the tumor location. The ophthalmic artery was bypassed during the super-selective arterial infusion.
RESULTS: No significant differences in biochemical indexes and Karnofsky performance status (KPS) score were observed before and after treatment, and no evident adverse events occurred (P>0.05). In a recent response evaluation (August 2023), two (8%) patients presented with a complete response (16.7%), four had a partial response (33.3%), four had stable disease (33.3%), and two showed progressive disease (16.7%). The overall response rate and disease control rate were 50.0% and 83.3%, respectively. In addition, we described the detailed course of treatment in two patients.
Case No 1 (recurrent tumor) and
case No 2 (primary tumor) received six and three cycles of teniposide infusion, respectively. After treatment, the tumors of the patients were significantly reduced without evident adverse effects.
CONCLUSIONS: This small series suggests that superselective IA cerebral infusion of teniposide may be a safe and effective therapy in the multimodal treatment of malignant glioma and warrants further study in larger prospective investigations.