手术后同步放化疗对脑胶质瘤患者预后的影响

Impact of postoperative concurrent chemoradiotherapy on the prognosis of patients with gliomas

目的探讨手术后同步放化疗对脑胶质瘤患者预后的影响,为改善患者的预后提供临床依据。方法选取2009年8月至2010年8月间收治的72例脑胶质瘤患者,按照随机数字表分为观察组和对照组,每组36例,均于外院接受脑胶质瘤手术后于我院接受放射治疗,观察组患者在此基础上接受化疗,比较两组患者的预后。结果观察组患者总有效率为77.8%,对照组患者总有效率为47.2%,两组比较差异有统计学意义(P<0.05)。观察组患者眼痛发生率高于对照组,差异有统计学意义(P<0.05);观察组患者骨髓抑制、恶心呕吐、发热及血常规变化发生率均低于对照组,差异均有统计学意义(均P<0.05);两组患者癫痫发生率差异无统计学意义(P>0.05)。两组患者治疗1年后肿瘤残余体积均显著降低,观察组肿瘤缩小率为73.9%,对照组为41.8%,两组比较差异有统计学意义(P<0.05)。观察组与对照组患者3年生存率分别为52.8%和16.7%,两组比较差异有统计学意义(P<0.05)。结论手术后同步放化疗可使脑胶质瘤患者生存预期得到有效改善,全身不良反应可耐受,有利于患者长期治疗,值得临床广泛推广。

Objective To explore the impact of postoperative concurrent chemoradiotherapy on the prognosis of patients with gliomas,so as to provide clinical evidence for improving the prognosis of patients. Methods 72 cases of brain glioma patients in other hospital for operation and in our hospital for chemotherapy in patients with brain glioma in August 2009 to August 2010 were randomly divided into observation group（ 36 cases） and control group（ 36 cases）,72 patients were treated with postoperative radiotherapy,the observation group patients also received chemotherapy,to compare the prognosis of patients in two groups. Results Objective response rate（ ORR） of observation group was 77. 8%,control group was 47. 2%,the observation group was significantly higher than that of control group; patients in the two groups after treatment were adverse reaction of different level,the eye pain of observation group patients were higher than those in control group,the difference was statistically significant（ P〈0. 05）; the observation group patients＇ bone marrow suppression,nausea and vomiting,fever and hemogram change rate is smaller than those in control group,the difference was statistically significant（ P〈0. 05）; the incidence of epilepsy there were no significant differences between the two groups of patients（ P〈0. 05）. 1 year after the cancer residual volume decreased significantly,the observation group tumor reduction rate was 73. 9%,41. 8% in the control group,the observation group decreased more obviously; the observation group and control group,3 years survival rate was 52. 8%,16. 7%,the survival rate of the observation group was significantly better than the control group（ P〈0. 05）. Conclusions Postoperative radiotherapy and chemotherapy can ensure the local drug concentration of tumor,to control tumor development,tumor recurrence,the survival is expected to improve,and systemic toxicity smaller,more conducive to long-term treatment of patients,is worthy of clinical application.