【摘要】 目的:观察替莫唑胶联合替吉奥治疗晚期胃肠胰腺神经内分泌肿瘤(GEP-NENs)的疗效及不良反应。方法:回顾分析2017年9月～2019年9月中日友好医院收治的15例经病理学确诊的Ⅳ期GEP-NENs患者,应用替莫唑胺联合替吉奥方案,对患者长期随访,分析治疗后的无进展生存期(PFS)并评定药物安全性。根据肿瘤组织O~6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)表达情况分为阴性组和阳性组,化疗6个疗程后,评价2组的客观有效率(ORR)。结果:化疗6个疗程后,15例中3例部分缓解(PR),10例疾病稳定(SD)。MGMT阴性组患者ORR为37.5%(3/8),高于MGMT阳性组(0/7)。中位无进展生存期(mPFS)约为13个月,2年生存率为80%(12/15)。化疗不良反应为1～2级的骨髓抑制、消化道反应和肝功能异常。结论:替莫唑胺联合替吉奥是治疗晚期GEP-NETs的有效化疗方案,患者耐受性比较好。基于替莫唑胺的化疗方案疗效可能与MGMT在肿瘤组织中的表达状态相关。更多还原

【Abstract】 Objective:To observe the efficacy and adverse reactions of Temozolomide combined with Tiggio in the treatment of advanced gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs).Methods:A retrospective analysis of 15 pathologically confirmed stage Ⅳ GEP-NENs patients admitted to China-Japan Friendship Hospital from September 2017 to September 2019 were treated with Temozolomide combined with Tiggio regimen,and the patients were followed up for long-term analysis and treatment progression free survival(PFS)and drug safety assessment.According to the expression of O~6-methylguanine DNA methyltransferase(MGMT)in tumor tissues,they were divided into MGMT-negative group and MGMT-positive group.After 6 courses of chemotherapy,the objective response rates(ORR)of the two groups were evaluated.Results:Three cases showed partial response,10 cases were stable disease(SD),median progression-free survival(mPFS) time was about 13 months,and the 2-year survival rate was 80%(12/15).After 6 courses of chemotherapy,the ORR of the MGMT negative group was 37.5%(3/8),which was significantly higher than that of the MGMT positive group(0/7).The adverse reactions were grade 1 to 2 bone marrow suppression,gastrointestinal reactions and liver function abnormalities.Conclusion:Temozolomide combined with Tiggio is an effective chemotherapy regimen for the treatment of advanced GEP-NETs,and patients are well tolerated.The efficacy of Temozolomide-based chemotherapy may be closely related to the expression status of MGMT in tumor tissues.更多还原