| 张 烨,姚 冰,陈 一.CD-DST药敏指导高级别胶质瘤术后辅助化疗的疗效研究[J].肿瘤学杂志,2018,24(4):346-350. |
| CD-DST药敏指导高级别胶质瘤术后辅助化疗的疗效研究 |
| Collagen Gel Droplet-embedded Culture Drug Sensitivity Test to Predict Responses in Postoperative Adjuvant Chemotherapy for High-grade Gliomas |
| 投稿时间：2017-11-08 |
| DOI：10.11735/j.issn.1671-170X.2018.04.B011 |
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| 中文关键词: 胶质瘤 胶滴肿瘤药敏检测技术 替莫唑胺 1p/19q |
| 英文关键词:glioma CD-DST temozolomide 1p/19q |
| 基金项目:辽宁省省直临床建设项目（LNCCC-B04-2015 ）；辽宁省科学事业公益研究基金（2014001008）；辽宁省中央引导地方科技发展专项项目（2017106014） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨胶滴肿瘤药敏检测技术（CD-DST）指导高级别胶质瘤术后辅助化疗的疗效，以及体外敏感性与1p/19q杂合性缺失基因变异相关性。［方法］ 2014年1月至2017年3月确诊高级别脑胶质瘤患者63例，手术肿瘤标本经CD-DST法标准处理后分别对替莫唑胺等5种化疗药物及组合进行检测，根据CD-DST结果指导规范术后辅助化疗方案；FISH探针法测定肿瘤组织1p/19q杂合性缺失基因变异。［结果］ 63例高级别脑胶质瘤患者体外CD-DST检测结果显示替莫唑胺、顺铂、VP-16、卡铂和卡莫司汀的T/C值分别为68.97%、75.43%、68.96%、79.59%和78.14%；联合方案T/C值分别为70.80%、62.23%、72.30%、63.97%和72.13%。CD-DST指导的行规范治疗与未行规范治疗患者的中位总生存期分别为14个月和6个月，差异有统计学意义（P<0.05）。1p/19q杂合性缺失19例（30.2%），1p/19q杂合性缺失组行规范治疗者中位总生存期显著优于未行规范治疗者（15个月vs 5个月，P<0.001）。［结论］CD-DST指导术后辅助化疗方案显著改善高级别脑胶质瘤的总生存，结合1p/19q杂合性缺失对于胶质瘤的治疗具有预后和治疗预测价值。 |
| 英文摘要: |
| Abstract：［Objective］ To evaluate the application of collagen gel droplet-embedded culture drug sensitivity test(CD-DST) in predicting responses of postoperative adjuvant chemotherapy for patients with high-grade gliomas. ［Methods］ From January 2014 to March 2017，63 patients with high-grade gilomas were enrolled in the study. The surgical specimens were collected and the CD-DST was performed for testing drug sensitivity. Among 63 patients，26 received chemotherapy guided by CD-DST(pilot group) and 37 were not (control group). And 1p/19q co-deletion in glioma cells were detected by FISH method. ［Results］ CD-DST showed that the sensitivity of glioma to temozolomide，cisplatin，VP-16，carboplatin and carmustine was 68.97%，75.43%，68.96%，79.59% and 78.14%，and the sensitivity to combined regimes was 70.80%，62.23%，72.30%，63.97% and 72.13%，respectively. The median overall survival(mOS) was 14 months in pilot group and 6 months in control group(P<0.05). 1p/19q co-deletion was detected in 19 of 63 cases(30.2%). The mOS of patients with 1p/19q co-deletion in pilot group was significantly higher than that in control group(15months vs. 5months，P<0.001). ［Conclusion］ Postoperative adjuvant chemotherapy guided by CD-DST significantly improves the overall survival in patients with high-grade gliomas，particularly for those with 1p/19q co-deletion. |
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