三维适形放射治疗联合替莫唑胺治疗脑胶质瘤的疗效及安全性

Efficacy and safety of 3-dimensional conformal radiotherapy combined with temozolomide for glioma

目的:探讨三维适形放射治疗联合替莫唑胺(temozolomide,TMZ)在脑胶质瘤治疗中的疗效和安全性。方法:2005年9月至2007年3月收治的78例脑胶质瘤术后患者分为3组,其中24例仅接受TMZ治疗(化学治疗组),25例仅接受三维适形放射治疗(放射治疗组),29例接受TMZ化学治疗联合三维适形放射治疗(综合治疗组)。观察各组生存率、无进展生存时间、总生存时间和不良反应。结果:综合治疗组的3年生存率明显高于其他两组,化学治疗组、放射治疗组、综合治疗组的3年生存率依次为20.83%,20.00%和41.38%;总平均无进展生存时间为17.68,17.94和23.29个月;平均总生存时间依次为20.28,21.54和25.75个月。患者的毒副反应轻,均可耐受。结论:三维适形放射治疗联合替莫唑胺是脑胶质瘤的有效治疗方法,优于单纯放射治疗和化学治疗,安全性良好,病人可以较好地耐受联合治疗。

Objective To study the efficacy and safety of 3-dimensional conformal radiotherapy combined with temozolomide（TMZ） for gliomas.Methods A total of 78 patients with pathologically confirmed glioma（from September 2005 to March 2007） were postoperatively divided into 3 groups： a chemotherapy group（n=24）,a radiotherapy group（n=25）,and a comprehensive therapy group（n=29）.The patients received temozolomide alone,3-dimensional conformal radiotherapy alone,3-dimensional conformal radiotherapy combined with temozolomide in the chemotherapy group,the radiotherapy group and the comprehensive therapy group respectively.The survival rate,progression-free survival,overall survival time and adverse reactions were observed.Results The 3-year survival rate in the comprehensive therapy group was significantly higher than that in the other two groups.The 3-year survival rates were 20.83%,20.00%,and 41.38% in the chemotherapy group,the radiotherapy group and the comprehensive therapy group respectively.The progression-free survival time was 17.68,17.94,and 23.29 months and the average overall survival time was 20.28,21.54,and 25.75 months in the chemotherapy group,the radiotherapy group and the comprehensive therapy group,respectively.The adverse reactions were mild and tolerable.Conclusion Three-dimensional conformal radiotherapy combined with temozolomide is more effective for gliomas than the simple 3-dimensional conformal radiotherapy and the temozolomide chemotherapy alone.