伽玛刀联合贝伐单抗治疗颅内恶性胶质瘤的疗效分析

Outcome analysis on gamma knife and bevacizumab against intracranial malignant gliomas

目的分析颅内恶性胶质瘤术后残留或复发患者接受伽玛刀联合贝伐单抗治疗与只接受伽玛刀治疗患者的近期肿瘤控制率、临床症状改善以及患者生存率的差别。方法总结2012-2015年中国人民解放军总医院第一附属医院神经医学中心收治的83例脑恶性胶质瘤术后复发患者的临床资料。其中接受伽玛刀联合贝伐单抗治疗40例（联合组）,接受伽玛刀治疗43例（伽玛刀组）,对两组患者治疗后定期复查比较近期疾病控制、临床症状改善及生存率的差别。结果所有患者随访4-42个月,随访率100%,联合组和伽玛刀组治疗中的患者6个月疾病控制率、1年生存率及2年生存率分别为92.5%和74.4%（P〈0.05）、74.2%和32.1%（P〈0.05）、56.4%和12.4%（P〈0.05）。结论伽玛刀联合小剂量贝伐单抗治疗颅内恶性胶质瘤是安全、有效的治疗方法,对患者治疗后近期肿瘤控制、生存质量的提高以及延长患者生存期有重要的作用。

Objective To compare the outcome of recurrent or residue malignant patients underwent Gama knife radiosurgery combined with or without bevacizumab. Methods 83 patients with malignant glioma,admitted from 2012 to 2015,were enrolled in this study. 40 patients were treated with combined therapy of Gamma knife and bevacizumab,and 43 with Gamma knife only.All these patients were followed up and analyzed by response rate and survival. Results All patients were followed up from 4 to 42 months and their response rate,survival and KPS were recorded. 6-month response rate was 92. 50% in combined therapy group and 74. 42% in Gamma knife group（ P 〈0. 05）. 1-year survival and 20-month survival were 72. 58% and 56. 42% in combined therapy group,while 32. 15% and 14. 40% in Gamma knife group（ P 〈0. 05）. Meanwhile KPS in combined therapy group was significantly higher than that in Gamma knife group（ P 〈0. 05）.Conclusion Combined therapy with Gamma Knife and bevacizumab was safe and effective for intracranial malignant glioma,which improves the response rate,survival and KPS significantly.