放化疗同步与单纯放疗治疗胶质母细胞瘤的疗效比较

Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma

目的比较单纯放疗（RT）与放疗加替莫唑胺（RT-TMZ）治疗胶质母细胞瘤的局控率、生存率及不良反应。方法对60例首次术后的胶质母细胞瘤随机分为接受单纯放疗、放疗加每天持续的替莫唑胺治疗以及6个周期的替莫唑胺辅助治疗。每组30例。主要研究目标为整体生存率。结果RT-TMZ组与RT组总有效率分别为53.3％和26．6％；1年累计局部复发率分别为63．3％和90．0％，1年无复发生存率分别为36．7％和10.0％，1年生存率分别为56．7％和16．7％（P〈0．05）。RT-TMZ组常见不良反应是恶心，呕吐，白细胞和血小板下降，但仅限于Ⅰ～Ⅱ度。结论在提高局控率、延缓肿瘤复发与提高患者无瘤生存期方面RT-TMZ组要优于RT组，而不良反应方面两组反应均较轻微。

Objective To compare the rate of local control, survival and safety in patients receiving radiotherapy alone （RT） and radiotherapy plus concomitant and adjuvant tcmozolomide （RT-TMZ） in postoperative patients with glioblastoma. Method 60 postoperative patients with glioblastoma were randomly divided into two groups： RT Group and RT-TMZ Group, each group have 30 patients. The primary end point was overall survial. Results The overall response rate in RT-TMZ Group and RT Group were 53.3% and 26. 6% respectively. The one-year cumulative local failure rate was 63. 3% and 90. 0% respectively. The one-year free from local failure survival rate was 36.7% and 10.0% respectively, The one-year survival rate was 56. 7% and 16.7% respectively （ P 〈 0.05 ）. The main side-effect including nausea, vomiting, leucopema, and thrombocytopenia were not serious （grade Ⅰ-Ⅱ ）. Conclusions The RT-TMZ Group was well in local control rate, delaying relapse and increasing relapse free survival rate compared with RT Group. The side-effect were little in both groups.