替莫唑胺同步放疗对不同MGMT表达的多形性胶质母细胞瘤的疗效及安全性分析

Efficacy and Safety of Temozolomide Combined with Radiotherapy in Treatment of Glioblastomas with Different MGMT Expression

[目的]研究替莫唑胺同步放疗对多形性胶质母细胞瘤的治疗效果及安全性。[方法]根据O6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)表达情况,分别选取2013年5月至2014年4月本院收治的MGMT阳性多形性脑胶质瘤患者(对照组)和MGMT阴性多形性脑胶质瘤患者(观察组)各41例。两组患者在放疗的同时使用替莫唑胺进行同步化疗。比较两组患者的临床疗效、治疗前后生活质量改善情况、不良反应。[结果]观察组总的有效率高于对照组[82.93%(34/41)vs 51.23%(21/41),χ~2=9.332,P=0.05]。治疗后,观察组的角色状态、躯体功能、心理健康、社会功能、精力、体力、疼痛生活质量评分显著低于对照组(P均<0.05)。观察组和对照组的胃肠道反应、骨髓抑制、重度疲乏及血液系统反应不良反应率比较差异无统计学意义(P=0.775,0.607,0.618,0.746)。[结论]MGMT阴性多形性脑胶质瘤患者采取替莫唑胺同步放疗进行治疗,近期疗效良好,能明显改善患者的生活质量。

[Objective] To evaluate the efficacy and safety of temozolomide combined with radiotherapy in treatment of glioblastomas with different expression of O6-methylguanine-DNA methyltransferase（MGMT）. [Methods] Forty one patients with MGMT-positive glioblastoma（control group） and 41 patients with MGMT-negative glioblastoma（study group） were enrolled from May 2013 to April 2014. All patients received radiotherapy concurrent with temozolomide chemotherapy. The clinical efficacy,quality of life and adverse reactions were compared between two groups. [Results] After treatment,the total effectiveness in study group was significantly higher than that in control group [82.93%（34/41） vs51.23%（21/41）,χ^2=9.332,P=0.05].The role status,physical function,mental health,social function,energy,physical strength,pain,quality of life score in study group were significantly lower than those in control group（all P〈0.05）. The bone marrow suppression,gastrointestinal reaction,severe fatigue and blood system adverse reaction had no significant differences between two group（P=0.775,0.607,0.618,0.746）. [Conclusion] Temozolomide chemotherapy concurrent with radiotherapy for the MGMT-negative glioblastoma patients has good short-term effect and it also can improve the quality of life of patients.