胶质母细胞瘤长周期替莫唑胺化疗的有效性和生存分析
Efficacy and Survival Analysis of Long-Term Temozolomide Chemotherapy for Glioblastoma
DOI: 10.12677/acm.2026.1631142, PDF,   
作者: 杨耀诚, 陆海军*：青岛大学附属医院肿瘤放疗科，山东 青岛；寻姝姝：金乡县人民医院肿瘤科，山东 济宁
关键词: 胶质母细胞瘤；替莫唑胺；长周期；中枢神经系统肿瘤；Glioblastoma； Temozolomide； Long Course of Treatment； Tumors of the Central Nervous System
摘要: 目的：探究术后同步放化疗后辅助替莫唑胺(temozolomide, TMZ)长周期化疗对于胶质母细胞瘤(glioblastoma, GBM)的有效性、可行性和患者生存分析。方法：回顾性收集自2019年1月1日至2021年12月31日首次就诊于我院的69例胶质母细胞患者的资料。依据WHO 2021 CNS分类标准，将IDH突变型患者(n = 10)单独分析，主要分析对象为IDH野生型GBM患者(n = 51)。根据辅助TMZ化疗周期数分为长周期(>6周期)组和标准周期(6周期)组，比较两组患者的无进展生存期(PFS)和总生存期(OS)。结果：本研究回顾性研究包括69例经病理确诊的胶质母细胞瘤患者，其中长周期治疗组患者33例，标准周期治疗组患者36例。所有患者的中位无进展生存期(progression free survival, PFS)为16.5个月；中位总生存期(overall survival, OS)为19.5个月，长周期治疗组和标准周期治疗组PFS分别为23.9个月和10.3个月(P < 0.001)；两组OS分别为37.6个月和１7.8个月(P < 0.001)。两治疗组的不良反应无统计学差异。单因素回归分析显示病灶部位(P = 0.031)、MGMT启动子甲基化(P = 0.021)、IDH突变(P = 0.036)、TMZ化疗周期数(P = 0.001)与患者PFS有关；MGMT启动子甲基化情况(P = 0.021)、TMZ化疗周期数(P = 0.001)与患者OS有关。多因素Cox分析显示MGMT启动子甲基化情况、TMZ化疗周期数为PFS、OS的独立影响因素。结论：同步放化疗后辅助长周期替莫唑胺化疗可以延长胶质母细胞瘤患者的无进展生存时间和总生存时间。
Abstract: Objective: To investigate the efficacy, feasibility and survival of long-cycle temozolomide (TMZ) chemotherapy for glioblastoma (GBM). Methods: The data of 69 patients with glioblastoma who first visited our hospital from January 1, 2019 to December 31, 2021 were retrospectively collected and analyzed. According to the 2021 CNS classification criteria of the WHO, the IDH-mutant patients (n = 10) were analyzed separately. The main analysis subjects were IDH wild-type GBM patients (n = 51). Patients were divided into standard cycle treatment group (6 cycles) and long cycle treatment group (>6 cycles) according to the number of temozolomide treatment cycles. The progression free survival (PFS) and overall survival (OS) outcomes were compared between two groups. Results: This retrospective analysis enrolled 69 patients with pathologically confirmed glioblastoma. There were 33 patients in the long-term treatment group and 36 patients in the standard treatment group. mPFS of the two groups were 23.9 months and 10.3 months, respectively, and the difference was statistically significant (P < 0.001). The mOS of the two groups was 37.6 months and 17.8 months in the long-term treatment group and the standard treatment group, respectively, and the difference was statistically significant (P < 0.001). Univariate regression analysis showed that PFS was correlated with lesion location (P = 0.031), O6-methylguanine-DNA methyltransferase promoter methylation (MGMTmet) (P = 0.021), Isocitrate Dehydrogenase (IDH) mutation (P = 0.036), and TMZ chemotherapy cycles (P = 0.001). The MGMTmet (P = 0.021) and the number of chemotherapy cycles of TMZ (P = 0.001) were related to OS. Multivariable Cox regression analysis indicated that the MGMTmet and the number of chemotherapy cycles of TMZ were the independent influencing factors of PFS and OS. Conclusion: Long-term TMZ treatment can prolong the progression free survival and overall survival of GBM patients.
文章引用：杨耀诚, 寻姝姝, 陆海军. 胶质母细胞瘤长周期替莫唑胺化疗的有效性和生存分析[J]. 临床医学进展, 2026, 16(3): 3367-3374. https://doi.org/10.12677/acm.2026.1631142

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