术后放、化疗时序对高级别脑胶质瘤疗效的影响

Different times and procedures of postoperative radiation and chemotherapy affecting treatment efficacy of high-grade gliomas

目的探讨术后不同放化疗时间窗及程序对高级别脑胶质瘤（HGO）疗效的影响。方法对71例术后HGG患者进行前瞻性临床研究。采用随机数字表法将其分入同步放化＋辅助化疗组（RC＋C组，39例）及早期化疗＋同步放化＋辅助化疗组（C＋RC＋C组，32例），比较2组患者的近期临床获益率（CBR）及无进展生存期（PFS）和总生存期fos）。结果治疗开始后5个月2组CBR差异无统计学意义（P〉0．05）；8个月时，C＋RC＋C组CBR为87．5％，RC＋C组为66．7％，差异有统计学意义（P〈0．05）。2组患者0S差异无统计学意义（P〉0．05）。C＋RC＋C治疗组的中位PFS为11．5月，RC＋C治疗组中位PFS为8．6月，差异有统计学意义（P〈0．05）。结论术后早期替莫唑胺化疗＋同步放化＋辅助化疗可显著延长HGG患者PFS。

Objective To investigate effects of different times and procedures of postoperative radiation and chemotherapy on treatment efficacy of high-grade gliomas. Methods A prospective clinical trial was conducted in 71 patients with high-grade gliomas （HGG）; they were separated randomly into two groups：one group including 39 patients received chemo-radiotherapy and adjuvant chemotherapy sequentially （RC＋C） and the other group including 32 patients received neo-adjuvant chemotherapy and chemo-radiotherapy and adjuvant chemotherapy sequentially （C＋RC＋C）. The clinical benefit rate （CBP）, progression flee survival （PFS） and overall survival （OS） were followed up after the treatment. Results No significant difference on CBP 5 months after treatment was noted between the two groups （P〉0.05）, but the CBP in the C＋RC＋C group （87.5%） was significantly higher than that in the RC＋C group （66.7%） 8 months after treatment （P〈0.05）. No significant difference on OS was noted between the two groups. The median PFS of patients in C＋RC＋C group was 11.5 months while that in the RC＋C group was 8.6 months; the PFS of patients in C＋RC＋C group was significantly longer that in the RC＋C group （P〈0.05）. Conclusion Procedure of C＋RC＋C can prolong the PFS of patients with HGG.