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首页> 外文期刊>European journal of neurology: the official journal of the European Federation of Neurological Societies >The efficacy of temozolomide for recurrent glioblastoma multiforme
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The efficacy of temozolomide for recurrent glioblastoma multiforme

机译：替莫唑胺治疗多形性胶质母细胞瘤的疗效

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Background and purpose: The efficacy of temozolomide (TMZ) in recurrent glioblastoma multiforme (GBM) has been evaluated by several clinical trials. A meta-analysis to assess the overall efficacy of TMZ in the treatment of recurrent GBM was carried out by the authors. Methods: Medline, EMBASE database and the Cochrane Library were searched for relevant studies. Eligible studies were clinical trials of recurrent GBMs assigned to TMZ with data on efficacy including tumor response, progression-free survival (PFS) or overall survival (OS) available. The overall efficacy was calculated using a random-effects or fixed-effects model, depending on the heterogeneity of the included trials. Results: A total of 15 phase II clinical trials including 902 recurrent GBMs were analyzed. The overall clinical benefit rate was 50.5% (95% CI: 44.3-56.7%) with significant difference between metronomic and standard schedules of TMZ (61.4% vs. 46.3%, P = 0.037). The overall 6-month PFS (PFS-6) rate was found to be 27.8% (95% CI: 22.7-33.5%) with significant difference between metronomic and standard schedules (33.1% vs. 20.1%, P 0.001). In addition, significant difference in PFS-6 was detected between high (average daily dose 100 mg/m2) and low (average daily dose ≤100 mg/m2) dose metronomic schedules (RR = 1.57, 95% CI: 1.17-2.09, P = 0.002). The overall 6-month OS (OS-6) and 12-month OS (OS-12) rates were 65.0% (95% CI: 57.4-71.9%) and 36.4% (95% CI: 26.9-47.1%) separately. There was no significant difference in OS-6 between metronomic and standard schedules (P = 0.266); however, a trend was noted favoring the metronomic schedule for OS-12 (P = 0.089). Conclusions: Temozolomide is effective for recurrent GBMs, and its efficacy may be increased with metronomic schedule and high average daily dose (100 mg/m2).
机译：背景与目的：已通过多项临床试验评估了替莫唑胺（TMZ）在多形性胶质母细胞瘤（GBM）中的疗效。作者进行了一项荟萃分析，以评估TMZ在治疗复发性GBM中的总体疗效。方法：检索Medline，EMBASE数据库和Cochrane库进行相关研究。合格的研究是分配给TMZ的复发性GBM的临床试验，其有效性数据包括肿瘤反应，无进展生存期（PFS）或总生存期（OS）。根据所纳入试验的异质性，使用随机效应或固定效应模型计算总体疗效。结果：共分析了15项II期临床试验，包括902例复发性GBM。总体临床受益率为50.5％（95％CI：44.3-56.7％），TMZ的计量学和标准方案之间有显着差异（61.4％对46.3％，P = 0.037）。发现6个月的总体PFS（PFS-6）率为27.8％（95％CI：22.7-33.5％），节拍和标准进度表之间存在显着差异（33.1％对20.1％，P <0.001）。此外，在高剂量（日平均剂量> 100 mg / m2）和低剂量（日平均剂量≤100mg / m2）低剂量组之间，PFS-6有显着差异（RR = 1.57，95％CI：1.17-2.09） ，P = 0.002）。总体6个月OS（OS-6）和12个月OS（OS-12）比率分别为65.0％（95％CI：57.4-71.9％）和36.4％（95％CI：26.9-47.1％）。在节拍计划表和标准计划表之间，OS-6没有显着差异（P = 0.266）;但是，注意到有一种趋势倾向于OS-12的节拍时间表（P = 0.089）。结论：替莫唑胺对复发性GBM有效，随着节律计划和日平均剂量高（> 100 mg / m2），其疗效可能会提高。

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