依托泊苷联合卡铂用于复发性髓母细胞瘤患儿的疗效与安全性

doi:10.12092/j.issn.1009-2501.2020.02.011

摘要/Abstract

摘要： 目的:探讨依托泊苷联合卡铂用于复发性髓母细胞瘤患儿的疗效与安全性。方法:选取浙江大学医学院附属儿童医院在2011年1月至2014年6月收治的72例复发性髓母细胞瘤患儿（3～15岁），随机分为CE组和对照组，每组36例，CE组采用依托泊苷＋卡铂给药方式化疗；对照组采用经典伊立替康＋替莫唑胺＋长春新碱方案化疗。比较两组患儿临床疗效、卡诺夫斯基健康状况量表（KPS）评分、儿科生活质量测定量表4.0（PedsQLTM4.0）评分、总生存期（OS）、无事件生存（EFS），记录患儿治疗期间药物不良反应的发生情况。结果:治疗后CE组和对照组完全缓解率（CR）分别为41.67%（15/36）和27.78%（10/36），总缓解率（OR）分别为94.44%（34/36）和77.78%（28/36），差异有统计学意义（P<0.05）。两组患儿治疗前KPS评分及PedsQLTM4.0评分无统计学差异（P＞0.05），治疗后CE组和对照组的KPS评分分别为（80±8）和（75±10）分，PedsQLTM4.0评分分别为（89±11）和（84±11）分，差异均有统计学意义（均P<0.05）。截至末次随访时间，CE组有3例失访，对照组有2例失访。截至末次随访时间，CE组和对照组总生存率分别为78.8%（26/33）和55.9%（19/34），差异有统计学意义（P<0.05），无事件生存率分别为72.7%（24/33）和52.9%（18/34），差异无统计学意义（P＞0.05）。CE组化疗期间共出现10例3级以上不良反应，发生率为27.78%（10/36），对照组化疗期间共出现9例3级以上不良反应，发生率为25.00%（9/36），差异无统计学意义（P＞0.05）。结论:依托泊苷联合卡铂方案能够明显提高患儿临床缓解率，延长患儿总生存率，同时不增加化疗不良反应，但对无事件生存率的影响并不明显。

关键词: 复发性髓母细胞瘤, 依托泊苷, 儿童, 化疗, 安全性

Abstract: AIM: To evaluate the efficacy and safety of etoposide combined with carboplatin in the treatment of recurrent medulloblastoma in children. METHODS: From January 2011 to June 2014, 72 children (aged 3-15 years) with recurrent medulloblastoma were selected from Childrens Hospital Affiliated to Medical College of Zhejiang University. According to the random number table method, they were divided into the CE group and control group, with 36 cases each. The CE group received etoposide + carboplatin for chemotherapy. The control group received classical irinotecan + temozolomide + vincristine chemotherapy. Clinical efficacy, KPS score, PedsQLTM4.0 score, total survival (OS) and event-free survival (EFS) of children in the two groups were compared, and the occurrence of adverse drug reactions during treatment was recorded. RESULTS:After treatment, CR of CE group and control group was 41.67% (15 cases/36 cases) and 27.78% (10 cases/36 cases), OR of CE group and control group was 94.44% (34 cases/36 cases) and 77.78% (28 cases/36 cases), and there were statistically significant different in these indicators between the groups. There was no significant difference in KPS scores and PedsQLTM4.0 scores between the two groups before treatment (P＞0.05). After treatment, KPS scores of the CE group and the control group were (80±8) and (75±10) points, and PedsQLTM4.0 scores were (89±11) and (84±11) points, and there were statistically significant different in these indicators between the groups (both P<0.05). By the time of the last follow-up, the overall survival rates of the CE group and the control group were 78.8% (26 cases/33 cases) and 55.9% (19 cases/34 cases), respectively, with statistically significant differences (P<0.05), and the EFS rates were 72.7% (24 cases/33 cases) and 52.9% (18 cases/34 cases), respectively, with no statistically significant differences (P＞0.05). A total of 10 cases with severe adverse reactions occurred during chemotherapy in the CE group, with an incidence of 27.78% (10 cases/36 cases), and 9 cases of that occurred during chemotherapy in the control group, with an incidence of 25.00% (9 cases/36 cases), with no statistical significance (P＞0.05). CONCLUSION: Etoposide combined with carboplatin regimen can significantly improve the clinical remission rate and improve the overall survival of children without increasing adverse reactions to chemotherapy, but the effect on event-free survival was not obvious.

Key words: recurrent medulloblastoma, etoposide, children, chemotherapy, safety

中图分类号:

R733
R72

潘露萍，石武杰，沈志鹏. 依托泊苷联合卡铂用于复发性髓母细胞瘤患儿的疗效与安全性[J]. 中国临床药理学与治疗学, 2020, 25(2): 189-195.

PAN Luping, SHI Wujie, SHEN Zhipeng. Efficacy and safety of etoposide combined with carboplatin in children with recurrent medulloblastoma[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2020, 25(2): 189-195.

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