恶性脑胶质瘤术后三维适形放疗联合三苯氧胺治疗的临床观察

Clinical observation of three dimensional conformal radiotherapy combined with tamoxifen in treatment of postoperative malignant glioma

目的：观察恶性脑胶质瘤术后三维适形放疗联合三苯氧胺治疗的疗效及不良反应。方法：60例恶性脑胶质瘤术后患者随机分为三维适形放疗联合三苯氧胺（治疗组）和三维适形放疗联合替莫唑胺（对照组）各30例。放疗采用6MVX线三维适形放射治疗,2.0Gy/次,1次/d,5次/周,DT56~60Gy。治疗组与对照组分别于放疗第一天开始口服三苯氧胺60mg/m2每日3次或替莫唑胺75mg/m2每日1次,至放疗结束。结果：治疗组与对照组1、2、3年生存率分别为63.3%、30.0%、23.0%和70.0%、33.3%、26.7%（χ2=0.01、0.23、0.09,P〉0.05）,无统计学差异。三苯氧胺主要不良反应为血栓栓塞,发生率为6.7%。结论：三维适形放疗联合三苯氧胺术后患者生存率较好,且价格便宜,并未增加不良反应,适合临床推广应用。

Objective：To evaluate the efficacy and adverse effects of three dimensional contormal radlomerapy （3DCRT） with tamoxifen for postoperative malignant glioma. Methods：Sixty patients with postoperative malignant gli- oma were randomized into two groups, thirty patients received 3DCRT plus tamoxifen （treatment group ） , 30 received 3DCRT plus temozolomide（ control group）. All patients were given 6MV X- ray,2.0Gy per fraction,once daily. The total dose varied up to DT 56 -60Gy. For treatment group regimen was tamoxifen：60mg/（ m2 ·d）, control group was temozolomide ：75mg/（ m2 · d）, concomitantly with radiotherapy. Results：The 1 - ,2 - ,3 -year survival rates were63.3% ,30.0% ,23.0% in treatment group,70.0% ,33.3% ,26.7% in control group（P 〉 0.05 ）. The thromboem- bolie rate in tamoxifen group was 6.7%. Coneluslon： The treatment of 3DCRT plus tamoxifen results in a good sur- vival rate relatively, with lower - cost and no increased toxicity, is suitable for clinical popularization and application.