Bevacizumab in combination with temozolomide capsules for treatment of recurrent glioblastoma

LI Qinggang; LIU Rui; ZHANG Jianning

doi:10.3969/j.issn.2095-3097.2018.03.005

Abstract：Objective To assess the efficacy and safety of the treatment using anti-angiogenic targeted drug bevacizumab combined with cytotoxic drug temozolomide ( TMZ) capsules in patients with recurrent glioblastoma. Methods In this retrospective study, 28 cases of recurrent glioblastoma were enrolled based on the inclusion criteria from June 2014 to December 2015 in Navy General Hospital. All cases received standard treatment of bevacizumab combined with TMZ after surgery. TMZ was given at 150 to 200 mg/m2 from day 1 to 5 every 4 weeks, and, bevacizumab was adminis-tered once every 14 days at 5 mg/kg through continuous intravenous infusion for 60 to 90 minutes. The short-term objective curative effects were evaluated based on response evaluation criteria in solid tumors. The Karnofsky performance scale ( KPS) and quality of life ( QOL) were scored before the treatment and before disease progressing post-treatment, respectively. Meantime, the toxicity of the treatment was assessed by using Common Toxicity Criteria of WHO. Results A total of 134 cycles and an average of 4. 8 cycles of this chemotherapy treatment were administered. All patients were re-ceived at least 2 cycles. In these 28 cases, 2 cases (7. 14％) were obtained complete remission, 9 cases (32. 14％) were partial remission, 12 cases ( 42. 86％) were stable disease, and 5 cases (17. 86％) were progression disease. The total remission rate was 39. 28％. The efficacy analysis showed a median progression-free survival was 5. 7 months (95％CI=3. 8～6. 7). In terms of overall survival, the median overall survival was 7. 2 months (95％CI=4. 6～7. 7). Improved KPS score and QOL score were observed after treatment, and this difference was significantly ( P<0. 05 ) . Additionally, some adverse reactions also were observed: bone marrow suppression in 19 cases ( 67. 86％) , gastrointestinal response in 12 cases ( 42. 86％) . The adverse reactions were classified with gradeⅠ ( 23. 40％) , grade Ⅱ ( 14. 72％) , grade Ⅲ ( 2. 30％) , and grade Ⅳ( 0 ) . Conclu-sion Bevacizumab combined with temozolomide capsules showed definite clinical curative efficacy in recurrent glioblastoma patients with some tolerable adverse reactions. This therapy appeared prom-ising in the treatment of recurrent glioblastoma.