Anlotinib Combined With Dose-dense Temozolomide for the First Recurrent or Progressive Glioblastoma After STUPP Regimen

Inclusion Criteria

• •1. The primary tumor must be pathologically confirmed as supratentorial glioblastoma;
• •2. The primary tumor progressed or relapsed for the first time after surgery (including biopsy, partial resection, total resection), standard radiotherapy and temozolomide concurrent chemotherapy and temozolomide adjuvant chemotherapy (STUPP regimen), including multiple intracranial recurrence and new lesions.;
• •3. Age ≥ 18 years old,≤75 years old;
• •4. KPS ≥ 60;
• •5. the expected survival time is more than 12 weeks;
• •6. within 28 days before entering the group, patients need to undergo craniocerebral enhanced MRI, and the lesions on MRI must be measurable;
• •7. for patients undergoing the second surgery after the first recurrence, baseline MRI should be obtained at least 4 weeks after operation;
• •8. if the patient is undergoing hormone therapy, the hormone dose must be stable or reduced at least 5 days before baseline MRI;
• •9. For patients undergoing re-radiation therapy, the baseline MRI should be obtained at least 8 weeks or 4 weeks after the end of the radiotherapy (the recurrence lesion is not in the radiation field);
• •10. For patients who are treated with gamma knife or other hyperdivision methods for the first time, Recurrence or progression must be confirmed by pathology (except for patients with new lesions);
• •11. Peripheral blood picture, liver and kidney function, etc. are within the following allowable range (detected within 7 days before the start of treatment): neutrophils (ANC) ≥ 1.5×109/L; hemoglobin (HGB) ≥100g/L; platelets (PLT) ≥100×109/L; liver transaminase (AST/ALT) ≤2.5 times the upper limit of the normal range; total bilirubin (TBIL) \<1.5 times the upper limit of the normal range; Creatinine (CREAT) \<1.2 times the upper limit of the normal range; International normalized ratio (INR) \<1.5; Activated partial thromboplastin time (APTT) \<1.5 times the upper limit of the normal range (except for patients receiving anticoagulation therapy); Urinary protein (PRO)/creatinine (CRE) ratio ≤1.0;
• •12. The patient must have fully recovered from the toxicity of previous chemotherapy or targeted therapy, and at least 30 days from the last treatment; 13.Before starting treatment, the patient must Complete recovery from surgery, postoperative infection or other comorbidities;
• •14.Patients of childbearing age (including female and male patients' female partners) must take effective birth control measures; 15.Sign informed consent.