恶性脑胶质瘤14例术后替莫唑胺联合放疗效果观察

Clinical study in three-dimensional conformal radiotherapy with concurrent chemotherapy in treatment of postoperative malignant gliomas

目的:探讨三维适形放疗(3D-CRT)联合替莫唑胺治疗(TMZ)术后高分级脑胶质瘤的疗效及安全性。方法:经术后病理证实为高分级胶质瘤28例,随机分成三维适形放射治疗并同期替莫唑胺化疗组(A组)和三维适形放射治疗组(B组)各14例。A组在三维适形放射治疗合并TMZ化疗,B组仅行放射治疗。两组患者放射治疗方法及剂量相同。结果:所有患者都经全脑CT或MRI显示肿瘤治疗有效率及疾病控制率:A组为54.54%和81.81%,B组为20.00%和30.00%。A组中位无进展生存时间(PFS)和总生存时间(OS)分别为14.00个月和21.00个月,B组中位PFS和OS分别为8.85个月和16.64个月。两组总的疾病控制率(DCR)、中位PFS和中位OS差异有统计学意义(P<0.05)。两组不良反应差异无统计学意义。结论:三维适形放射治疗联合替莫唑胺治疗术后高分级的脑胶质瘤的疗效优于单纯放射治疗且不良反应轻。

Objective：To observe the efficacy and safety of temozolomide（TMZ） plus concomitant 3-dimension conformal radiotherapy（3D-CRT） in patients with postoperative malignant glioma.Methods：28 postoperative malignant glioma were randomly divided into A group 14 cases,B group 14 cases.A group patients receive TMZ concomitantly with 3D-CRT.B group patients only receive RT.Results：Whole-brain CT or MRI showed the response rates（RR） and disease contral rates（DCR）.There were respectively 54.54% and 81.81% in A group.There were respectively 20.00% and 30.00% in B group.The mid-PFS and mid-OS were 14.00 months,21.00 months and 8.85 months,16.64 months respetively in A group and B group.The DCR,mid-PFS and mid-OS had significant difference in two groups（P0.05）.Conclusion：3D-CRT combined with TMZ could be more effective than RT alone in postoperative malignant glioma and no more adverse effect.