The Efficacy And Safety Of Apatinib Combined With Dose-intensive Temozolomide In The Treatment Of Recurrent Malignant Glioma With High Perfusion

Purpose:This subject mainly studies the efficacy and adverse reactions of apatinib combined with dose-dense temozolomide in the treatment of recurrent malignant glioma with high perfusion Method:In this study,We included patients with recurrent malignant gliomas in our department of oncology who had functional cranial magnetic resonance imaging suggesting high blood flow.The patient takes apatinib(250mg,qd)combined with temozolomide dose-density regimen(100mg/ ?,every 28 days as a cycle,administered on days 1-7 and 15-21 days,ie 7/14 d regimen)The RANO criterion is used to evaluate the therapeutic effect of patients,and the side effects are evaluated according to NCT-CTCAE 4.0Result1.A total of 23 patients were enrolled,including 14 cases of glioblastoma with WHO grade IV,WHO grade ? glioma accounts for 9 cases,21 patients were first relapse and 1 patient were second relapse.One case failed chemotherapy after relapse.There were 13 female patients and 10 male patients,median age was 49 years(31-62years).The median KPS score before treatment was 70 points(60-80 points),and the median KPS score after treatment was 80 points(50-90 points).2.The results showed that in the whole group,there were 15 cases of PR,6 cases of SD,2 cases of PD,and 0 cases of CR.ORR was 65.2%(15/23)and DCR was91.3%(21/23).Among them,9 cases of glioblastoma were PR,4 cases of SD,1 case of PD,6 cases of grade III glioma were PR,2 cases of SD,and 1 case of PD.The ORR of glioblastoma was 64.3%(9/14),DCR was 92.8%(13/14),the ORR of grade III glioma was 66.7%(6/9),DCR was 88.9%(8/9).The median PFS of the whole group was 7.0 months(95% CI: 5.91-8.09),and the 6-month PFS rate was 65.2%.Among them,the median PFS of glioblastoma was 6.0 months(95% CI: 5.08-6.92),the PFS rate of 6 months was 57.1%,and the median PFS of grade III glioma was 8.8months(95% CI: 7.34-10.26),6-month PFS rate was 77.8%.3.Toxic side effects: No grade 3 and above toxic side effects occurred,no treatment-related deaths,only grade 1-2 side effects.The main side effects was hand-foot syndrome(30.4%),and gastrointestinal reactions(30.4%),hypertension(26.1%),Fatigue(21.7%),proteinuria(13.0%),leukocytopenia(13.0%).Conclusion:Apatinib combined with dose-dense temozolomide is effective in the treatment of recurrent malignant glioma with high blood flow,the toxic and side effects can be tolerated.