脑恶性胶质瘤术后适形放疗联合不同形式化疗的临床观察

Effects of three-dimensional conformal radiotherapy combined with different chemotherapy in treatment of post-operative malignant glioma

目的:探讨脑恶性胶质瘤术后适形放疗联合不同形式化疗的疗效和安全性。方法:68例术后病理证实为脑恶性胶质瘤的患者,术后采用单纯适形放疗(RT)21例,采用尼莫司汀间质化疗同步适形放疗(ACNU+RT)24例,采用替莫唑胺化疗同步适形放疗(TMZ+RT)23例,比较3组疗效的安全性。结果:RT组患者1、2、3a存活率分别为47.6%(10/21)、23.8%(5/21)、15.0%(3/21),中位生存时间为11.0(18.2～7.6)个月,ACNU+RT组分别为75.0%(18/24)、41.7%(10/24)、20.8%(5/24)和20.0(35.4～12.2)个月,TMZ+RT组分别为73.9%(17/23)、43.4%(10/23)、21.7%(5/23)和21.0(33.6～12.2)个月。ACNU+RT组、TMZ+RT组中位生存时间长于RT组(χ2L=8.313,8.825;P<0.05)。结论:ACNU+RT和TMZ+RT可作为脑恶性胶质瘤术后的综合治疗方案。

Aim：To investigate the efficacy and safety of three-dimensional conformal radiotherapy combined with different chemotherapy in the treatment of post-operative malignant glioma.Methods：A total of 68 postoperation patients with malignant glioma were collected,among whom,21 accepted performed three-dimensional conformal radiotherapy alone（RT group）,24 accepted nimustine interstitial chemotherapy combined with RT（ACNU＋RT group） and 23 accepted temozolomide chemotherapy concurrent combined with RT（TMZ＋RT group）.All patients were followed up for observation of median survival time,and 1,2,3-year survival rates.Results：The survival rates of 1,2 and 3 years of RT group were 47.6%（10/21）,23.8%（5/21）and 15.0%（3/21）,and the median survival time was 11.0（18.2～7.6）months.The survival rates of 1,2 and 3 years of ACNU＋RT group were 75.0%（18/24）,41.7%（10/24）and 20.8%（5/24）,and the median survival time was 20.0（35.4～12.20）months.The survival rates of 1,2 and 3 years of TMZ＋RT group were 73.9%（17/23）,43.4%（10/23）and 21.7%（5/23）,and the median survival time was 21.0（33.6～12.2） months.The median survival time of ACNU＋RT group and TMZ＋RT group were significantly longer than that of RT group（χ2L=8.313,8.825,P0.05）.Conclusion：Both ACNU＋RT and TMZ＋RT could be used for the comprehensive treatment of malignant glioma.