替莫唑胺联合生物疗法预防晚期黑色素瘤脑转移临床分析
Clinical Analysis of Efficacy Preventing Brain Metastases Treated with Temozolomide and Biotherapy in Malignant Melanoma
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摘要: 目的 评价接受替莫唑胺+铂类+生物治疗及传统药物达卡巴嗪+铂类+生物治疗不同方案治疗晚期黑色素瘤1年中脑转移情况；探讨O6－甲基鸟嘌呤－DNA甲基转移酶(MGMT)表达与替莫唑胺疗效的关系。 方法 88例晚期黑色素瘤患者中52例接受替莫唑胺+顺铂化疗6周期,36例患者接受达卡巴嗪+顺铂化疗6周期,观察治疗1年后两组脑转移发生率及MGMT表达与替莫唑胺疗效的关系。 结果 替莫唑胺组治疗1年后仅有2名患者发生脑转移，发生率为3.85%;达卡巴嗪组6名患者发生脑转移,发生率为16.67%。MGMT (-)组疾病控制率为80％，MGMT（+～++）组40.91％。 结论 替莫唑胺治疗组脑转移率明显下降。MGMT表达与替莫唑胺药效有关,MGMT表达阴性治疗有效率更高。治疗前检测MGMT的表达情况，可预测化疗敏感性，制定个体化治疗方案，克服耐药，提高治疗效果。Abstract: Objective To compare the incidence proportions of brain metastases in malignant melanoma patients treated with TMZ plus Cisplatin-based or DTIC-based chemobiotherapy for one year. We further investigated the correlation between MGMT expression and efficacy of TMZ. Methods In 88 cases, 52 patients with malignant melanoma were administered with TMZ and 36 patients were treated with DTIC for one year, then the incidence of brain metastases were calculated and the relationship between the MGMT expression and the efficacy of TMZ were analyzed. Results In TMZ-treated group there were 2 (3.85%) patients with brain metastases. The numbers of brain metastases in the other group were 6 (16.67%). The disease control rate in MGMT negative expression group was 80%, whereas, in MGMT positive expression group it was 40.91%. Conclusion The number of patients with brain metastases was low in TMZ-treated group.The efficacy of TMZ-based chemotherapy is associated with MGMT expression. High efficacy of TMZ treatment was found in patients without MGMT expression.
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