高级别脑胶质瘤术后三维适形放疗联合替莫唑胺化疗的疗效观察

Three-dimensional Conformal Radiotherapy with Temozolomide in the Treatment of Postoperative High-grade Gliomas

背景与目的:国外已有同期放/化疗治疗高级别脑胶质瘤成功经验。本研究观察术后三维适形放疗加替莫唑胺同步和辅助化疗治疗高级别脑胶质瘤的近期疗效和不良反应。方法:收集2003年1月至2006年12月收治的21例高级别脑胶质瘤部分切除术后患者,行三维适形放疗[2.0Gy/(次·d),5d/周,总剂量60～70Gy],替莫唑胺同步化疗6～7周+辅助化疗3～6疗程。结果:本组21例患者有效率为81.0%,6个月无疾病进展生存率为76.2%(16/21),1年无疾病进展生存率52.4%(11/21),1年生存率为71.4%(15/21);患者对治疗的耐受性良好,常见的不良反应为头痛、恶心、呕吐和乏力。结论:高级别脑胶质瘤术后三维适形放疗联合替莫唑胺化疗近期疗效良好,且患者对治疗的耐受性好,是切实可行的治疗方案。

BACKGROUND ＆ OBJECTIVE：Improvement of the prognosisof patients with high-grade gliomas treated with post-operative radiotherapy concomitant with temozolomide was reported in literatures. In this study, we aimed to observe the clinical efficacy and side effects of three-dimensional conformal radiotherapy concomitant with temozolomide in the treatment of postoperative high-grade gliomas in Chinese patients. METHODS： Twenty-one high-grade glioma patients previously treated withpartial resection of the tumor received three-dimensional conformal radiotherapy with concomitant and adjuvant temozolomide chemothreapy. RESULTS： The overall response rate was 81%. progression-free survival was 76.2%（16/21） at 6 months and 52.4%（11/21） at 1 year respectively. The one-year survival rate was 71.4% （15/21）. All patients could well tolerate this treatment scheme. The main side effects were headache, nausea, vomit and fatigue. CONCLUSIONS： Three-dimensional conformal radiotherapy concomitant with temozolomide in the treatment of postoperative high-grade gliomas demonstrates good tolerance and achieved fair short-term efficacy.