血脑屏障开放后放疗联合替莫唑胺化疗治疗脑胶质瘤的临床研究

Efficacy and safety radiotherapy plus concomitant and adjuvant chemotherapy of temozolomide for glioma patients after open blood brain barrier

目的:观察血脑屏障开放后放疗联合替莫唑胺化疗治疗脑胶质瘤的疗效和不良反应。方法:研究对象为2008年2月～2010年6月共31例术后经病理证实为脑胶质瘤患者,其中WHO病理分级Ⅱ级11例,Ⅲ～Ⅳ级20例。放疗至2000cGy(血脑屏障开放)后给予替莫唑胺50～70mg/m2/d;同期放化疗结束4周后,继续予替莫唑胺口服辅助化疗150～200mg/m2/d,d1～5,28天为一个化疗周期,共5～6个周期。结果:完全缓解3例,部分缓解25例,疾病稳定3例,有效率达90.5%。其中Ⅱ级患者有效率为100%,Ⅲ～Ⅳ患者有效率为80%。1年无进展生存率为80.6%,总生存率为83.9%,其中Ⅱ级患者的一年无进展生存率和总生存率均为100%,Ⅲ～Ⅳ级患者的一年无进展生存率和总生存率分别为75%和80%。不良反应轻,患者耐受较好。结论:血脑屏障开放后放疗联合替莫唑胺化疗治疗脑胶质瘤的近期疗效好且不良反应轻。

Ohiective：to observe the efficacy and safety after open blood brain barrier,radiotherapy plus concomitant and adjuvant chemotherapy of temozolomide for glioma patients.Methods：thirty-one were enrolled beteen February 2008 and June 2010,including 11 cases of grade Ⅱ and 20 cases of grade III- 1V within the WHO 2000 classification.All patients plus concomitant and adjuvant chemotherapy of temozolomide （50~70mg/m2/d）after receieved radiotherapy with a dosage of 2000cGy （blood brain barrier opened）,followed by 5-6 cycles of adjuvant TMZ （150~200mg/m2/d,d1-5）4weeks after radiotherapy.Results：there were 3 cases of complete response （CR）,25 eases of partial re- sponse（PR）,and 3 cases of stable disease（SD）,and the overall response rate（CR＋PR） was 90.5%.the overall response rates of patients with grade Ⅱ and Ⅲ-Ⅳ were 100% and 80%.the one-year progress-free survival rate was 80.6% and the overall survival rate was 83.9%,which were both 100% in grade Ⅱ ,whereas 75% and 80% in grade Ⅲ-Ⅳ,renspectively.All patients in this study could tolerate the regimen .Conclusion： Radiotherapy plus concomitant and adjuvant chemotherapy of temozolomide for glioma patients after open blood brain barrier has a higher short-term efficacy with less side effects.