替莫唑胺治疗恶性脑胶质瘤的临床研究

Clinical effect of temozolomide on treatment of malignant glioma

目的探讨替莫唑胺治疗恶性脑胶质瘤的临床疗效。方法将本院诊治的60例恶性脑胶质瘤患者随机分入单纯放疗组与综合治疗组,单纯放疗组患者接受三维适形放射治疗,综合治疗组患者在三维适形放疗基础上同时接受替莫唑胺化疗。比较2组近期疗效、3a生存率、平均生存时间、中位复发时间及不良反应发生率。结果综合治疗组治疗有效率及疾病控制率分别为66.7%和90.0%,显著高于单纯放疗组36.7%和66.7%(P<0.05);综合治疗组与单纯放疗组3a生存率分别为46.7%和16.7%,差异具有统计学意义(P<0.05);综合治疗组平均生存时间及中位复发时间均显著优于单纯放疗组(P<0.05);骨髓抑制及消化道症状是2组主要的不良反应,2组不良反应发生率差异无统计学意义(P>0.05)。结论在三维适形放疗基础上给予替莫唑胺治疗,可显著延长恶性脑胶质瘤患者生存期,且不增加不良反应。

Objective To explote the efficacy of temozolomide on malignant glioma. Methods 60 cases wnn maugnant gu- oma were randomly divided into radiotherapy group and comprehensive treatment group. Radiotherapy group received three di- mensional conformal radiation therapy, and comprehensive treatment group were treated with temozolomide based on radiother- apy treatment. Short-term effect, 3 years survival rate, the mean survival time, the median relapse time and adverse rates were compared between two groups. Results The effective rate of treatment and disease control rate in comprehensive treatment group were 66.7 % and 90.0 %, of which were significantly higher than those in radiotherapy group（36.7 % and 66.7%, P〈 0.05）. The 3 year survival rates were 46.7% and 16.7% in comprehensive treatment group and radiotherapy group respectively with significant difference （P〈0.05）. The mean survival time and the median relapse time in comprehensive treatment group were superior to radiotherapy group （P〈0.05）. Bone marrow depression and gastrointestinal toxicity were the main side effects in two groups. There were no significant difference of adverse rates between two groups （P〉0.05）. Conclusion Three dimensional conformal radiation therapy combined with temozolomide can greatly improve the survival time of patters with ma- lignant glioma,with less adverse rate.