Survival Status of Patients with Recurrent High-Grade Glioma After the First Combination Therapy with Carmustine and Temozolomide and Its Influencing Factors
Objective To investigate the survival status of patients with recurrent high-grade glioma after the first combination therapy with carmustine and temozolomide and its influencing factors.Methods A total of 156 patients admitted to the Affiliated Hospital of Hebei University of Engineering from September 2015 to August 2020 were selected and divided into the control group(56 cases)and the observation group(100 cases)according to different treatment regimens.The patients in the two groups were treated with Temozolomide for Injection,on this basis,the patients in the observation group were treated with Carmustine Injection.Both groups were treated for 12 weeks and followed up for three years.The statistically significant indicators were screened by the univariate analysis,the influencing factors of patients´ survival status after combination therapy were explored by the multivariate Logistic regression analysis.Results The objective remission rate and disease control rate in the observation group was 66.00%,97.00%respectively,which were significantly higher than 33.93%and 78.57%in the control group(P<0.05).A total of 64 cases(64.00%)survived and 36 cases(36.00%)died in the observation group.The incidence of adverse reactions in the observation group was similar to that in the control group(13.00%vs.10.71%,P>0.05).The multiple regression analysis showed that the maximum lesion area[OR=36.000,95%CI(5.246,247.061),P<0.001],relative cerebral blood volume(rCBV)[OR=2.228,95%CI(1.282,3.871),P=0.004],relative cerebral blood flow(rCBF)[OR=1.713,95%CI(1.011,2.904),P=0.046]and relative permeability surface-area product(rPS)[OR=1.524,95%CI(1.129,2.057),P=0.006]were the independent risk factors for the survival status of patients.Conclusion Compared with temozolomide alone,the addition of carmustine can further improve the short-term efficacy in patients with recurrent high-grade glioma.The maximum lesion area,rCBV,rCBF and rPS are the independent risk factors for the survival status of patients after the first combination therapy with carmustine and temozolomide.The effects may be related to the invasiveness of tumor cells,tumor microenvironment,and blood supply in the tumor area reflected by the above factors.
万方数据
维普
