成人弥漫性低级别胶质瘤替莫唑胺化疗的临床研究

Clinical research on temozolomide chemotherapy for adult diffuse low-grade gliomas

目的：比较成人弥漫性低级别胶质瘤患者手术加常规分割放疗后加替莫唑胺化疗（化疗组）和不加替莫唑胺化疗（对照组）的无进展生存时间（progression free survivaltime，PFS），明确化疗对于成人弥漫性低级别胶质瘤患者的治疗意义。方法：回顾性分析首都医科大学附属北京天坛医院神经外科于2005年5月至2008年4月收治的64例成人弥漫性低级别胶质瘤患者，其中对照组（46例）行手术后仅接受放疗，化疗组（18例）行手术和放疗后，接受替莫唑胺化疗4～12个周期，比较两组患者的PFS是否存在显著性差异。结果：化疗组的中位PFS为67．8个月，对照组的中位PFS为51．3个月。采用Kaplan-Meier生存分析的Log-rank法进行险验（χ2=8．741，P=0．003），差异具有统计学意义。结论：成人弥漫性低级别胶质瘤患者接受替莫唑胺化疗能提高PFS。

Objective： To compare the therapy effects of chemotherapy and non-chemotherapy groups and to determine the value of chemotherapy for adult diffuse low-grade gliomas. Methods： We reviewed and analyzed 64 patients with adult diffuse low-grade gliomas admitted to the Beijing Tiantan Hospital from May 2005 to April 2008. Among the patients, 18 received 4 to 12 cycles of temozolomide chemotherapy after operation and radiotherapy, whereas the other 46 cases only received radiotherapy. The progression-free survival of the two groups was compared. Results： The median progression-free survival of the chemotherapy and the control groups were 67.8 and 51.3 months, respectively. The results of the comparison implied a significant difference （X2=8.741, P=0.003）. Conclusion： Chemotherapy can improve the progression-free survival of the patients with adult diffuse low-grade gliomas, and thus, can be recommended as its effective therapy.