胶质母细胞瘤手术联合精准的放化疗疗效

Effect of postoperative radiotherapy and chemotherapy on glioblastoma

目的分析胶质母细胞瘤采用手术联合精准的放化疗的疗效。方法观察空军军医大学第二附属医院放射治疗科78例胶质母细胞瘤患者的临床资料,所有患者均经手术切除,术后进行同步放化疗及辅助化疗。放射治疗靶区通过CT与MRI进行融合进行勾画,采用适形调强方式进行治疗,采用RANO标准进行患者的近期疗效评价,Kaplan-Meier曲线进行生存期分析。结果放疗前KPS评分、切除范围、ki-67表达、IDH-1、放疗与手术间隔时间、替莫唑胺辅助治疗周期等影响患者的预后。放疗结束后1个月随访,疗效评价CR 8.9%,PR 26.9%,有效率为35.8%。全组患者的中位无进展生存期为9.3个月,中位总生存期为15.6个月,1、2年总生存率分别为65.4%、29.2%。结论胶质母细胞瘤采用手术联合精准的放化疗可以使患者生存获益。

Objective To investigate the curative effect of postoperative radiotherapy and chemotherapy on glioblastoma.Methods Seventy-eight patients with glioblastoma who underwent surgery plus concomitant radiotherapy and TMZ chemotherapy followed by adjuvant TMZ,were included in the study.Target volume was determined by fusion technique of CT and MRI and all patients received intensity modulated radiation therapy.Short-term effect was evaluated by the RANO standard and the survival rate was calculated by Kaplan-Meier curve.Results The KPS score before radiotherapy,IDH-1,ki-67,the interval time between radiotherapy and surgery and the cycles of temozolomide chemotherapy were associated with the prognosis of the patients.The total rate of complete response,partial response and response were 8.9%,26.9%and 35.8%.The median progression-free survival time was 9.3 months and the total median survival time was 15.6 months.OS rates at 1 year and 2 years were 65.4%and 29.2%.Conclusion The patients with glioblastoma can benefit from surgery combined with accurate radiotherapy and chemotherapy.