三维适形放疗联合替莫唑胺化疗用于恶性脑胶质瘤术后疗效观察

目的探讨三维适形放疗（3DCRT）联合同步替莫唑胺（TMZ）化疗用于恶性脑胶质瘤术后的临床疗效及不良反应。方法40例恶性脑胶质瘤术后，采用3DCRT同步联合TM2（RT-TMZ组）与单纯放疗（RT组）患者对照分析。RT-TMZ组（20例）采取局部放疗同时每天持续口服TMZ化疗（75mg／m^2）以及TMZ化疗（150-200mg／m^2）3～6个周期的辅助治疗；RT组（20例）采取单纯放射治疗（60～72Gy）。结果RT-TMZ组疗效好于RT组，RToTMZ组与RT组比较有效率分别为75．0％和60．0％，差异有统计学意义（P〈0．05）。1、2年生存率分别为75．0％、45．0％和40．0％、15．0％差异有统计学意义（P〈0．05）。中位生存期分别为15．9个月9．8个月。RT-TMZ组不良反应轻微，限于Ⅰ～Ⅱ级。结论放疗联合同步TMZ化疗用于恶性脑胶质瘤术后的疗效优于单纯放疗，而且患者的化疗不良反应无明显增加。

Objective To evaluate the treatment efficacy and adverse effects of three dimensional conformal radiotherapy （ 3DCRT ） combined with concurrent temozolomid in treatment of malignant glioma. Methods 40 postoperative patients with malignant intracranial glioma admitted to our hospital were divided into RT-TMZ Group （ n=20 ） and RT Group （ n=20 ） .Patients in RT-TMZ group received radiotherapy with a total dosage of 60-72Gy and chemotherapy with concomitant oral temozolomide （ TMZ ） , 75 mg/ m2/d, followed by 3-6 cycles of adjuvant TMZ, 150-200mg/m2/d. Patients in RT group received only radiotherapy with a total dosage of 60-72Gy. Results Concurrent TMZ chemoradiotherapy was effective for malignant intracranial glioma, The response rates were 75.0%and 60.0%, respectively, P〈0.05.The 1-, 2-year survival rates in RT-TMZ Group and RT Group were75.0%, 45.0%and 40.0%, 15.0%, respectively, P〈0.05.The median survivaU time was 15.9 months in RT-TMZ Group and 9.8 months in RT Group.The main side effects were limited to grade Ⅰ or grade Ⅱ. Conclusion Concurrent TMZ chemoradiotherapy can achieve good results in the survival of malignant intracranial glioma, without increasing the toxicity.