替莫唑胺联合同步整合推量调强放疗治疗脑转移瘤的疗效观察

Therapeutic effect of temozolomide combined with simultaneous integrated push-pusto-intensity radiotherapy for brain metastases

目的探讨替莫唑胺联合同步整合推量调强放疗治疗脑转移瘤的疗效观察.方法回顾性分析我科2015年1月~2016年12月收治的脑转移瘤患者共68例,观察组32例为替莫唑胺联合放疗治疗组,全脑剂量为每次2Gy,转移灶剂量为每次3Gy,共18次,每周5次,同步替莫唑胺75mg/m2/d.对照组36例为单纯调强放疗组,放疗方法与观察组相同.所有患者治疗结束后进行随访,随访时间至2018年12月.比较两组患者的有效率及1y、2y生存率,放疗期间的毒副反应等.结果两组患者均按计划完成治疗.观察组的有效率及1y、2y生存率显著高于对照组(P<0.05),两组间的骨髓抑制、消化系统反应、神经系统损伤发生率比较,差异均无统计学意义(P>0.05).结论替莫唑胺联合同步整合推量调强放疗治疗脑转移瘤可以更好地提高脑转移瘤患者有效和1y、2y生存率,与单纯放疗组相比,毒副反应未见明显增加.

0bjective To investigate the therapeutic effect of Temozolomide Combined with simultaneous integration of IMRT on brain metastasis.Methods A total of 68 patients with brain metastasis from January 2015 to December 2016 in our department were analyzed retrospectively.32 patients in the observation group were treated with temozolomide combined with radiotherapy.The whole brain dose was 2Gy per time,and the metastasis dose was 3Gy per time,a total of 18 times,5 times per week,with temozolomide 75mg/m^2/d.36 cases in the control group were treated with IMRT alone,and the radiotherapy method was the same as that in the observation group.All patients were followed up until December 2018.The effective rate,ly,2y survival rate and side effects during radiotherapy were compared between the two groups.Results The patients in both groups completed the treatment according to the plan.The effective rate and ly and 2y survival rate of the observation group were significantly higher than those of the control group(P<0.05).There was no significant difference in the incidence of myelosuppression,digestive system reaction and nervous system injury between the two groups(P>0.05).Conclusion Temozolomide Combined with IMRT can improve the effective and 1y,2y survival rate of patients with brain metastases.Compared with radiotherapy alone,there is no significant increase in side effects.