术后同期放化疗治疗恶性脑胶质瘤疗效观察

Observation on the clinical effect of postoperative concurrent chemoradiotherapy for high - grade gliomas

目的探讨恶性胶质瘤术后同期放化治疗的疗效。方法选取49例脑胶质瘤部分切除术后患者，随机分为两组：单纯放疗组19例，仅行三维适形放疗，分次局部照射，40Gy／20f／4周，后改野加量至61—64Gy／27—28f/5～6周；全部治疗时间为5—6周；联合治疗组30例，于三维适形放疗后两周联合司莫司汀辅助化疗6疗程。观察患者肿瘤体积的变化及Kamofsky评分评价精神状态，并记录生存时间。结果放疗结束6月后，联合治疗组影像学所示肿瘤实体的缩小和身体状态的改善方面均优于单纯放疗组（均P〈0．05），同时联合治疗组远期生存期亦明显优于单纯放疗组。结论放疗联合司莫司汀化疗可提高脑胶质瘤部分切除术后肿瘤缓解率和患者生活质量，并延长其生存期。

Objective To compare the efficacy of the therapeutic alliance of radiotherapy and Semustine （CCNU） chemotherapy with radiotherapy alone after partial resection of high-grade gliomas. Methods Forty-nine cases with partial resection of brain gliomas were randomly divided into two groups. In the control group （ sole radiotherapy n = 19 ） , patients were only treated with local radiotherapy ,with the dose of 40Gy/20f/4W, and then added the amount to 61 -64Gy/27 - 28f/5 -6W with low fractionation radiotherapy. In the observation group （therapeutic alliance n = 23 ）, patients underwent the above mentioned radiotherapy plus six courses of adjuvant CCNU chemotherapy. Meanwhile, enhanced GD-MRI was performed to evaluate the changes of glioma volume,the nerve function status was evaluated with Karnofsky scale,and record the survival time. Results Twenty-four weeks after radiotherapy,improvements in glioma size and nerve function status of the obsenrvation group were superior than that in the control group（ all P 〈 0.05）, meanwhile, the long-term survival rate of observation group was also significantly better than that of the control group（ P 〈 0.05）. Conclusion Radiotherapy combined with CCNU could increase the glioma remission rate after partial resection, improve the life quality of patients, and extend their survival time.