微波热疗辅助放化疗在脑胶质瘤中的应用研究

Application of microwave hyperthermia assisted chemoradiotherapy in brain glioma

目的 探讨微波热疗辅助放化疗对脑胶质瘤患者近期脑部症状、伴随症状的改善、治疗依从性和满意度的影响。方法 本研究入组2022年6月至2024年3月郑州大学第一附属医院放疗科脑胶质瘤患者80例,观察组46例,对照组34例。对照组按照NCCN指南采用放疗和化疗方案,放疗采用容积弧形调强放疗技术,总剂量为50~60G y, 1.8~2.00 Gy/次,5次/周;化疗采用替莫唑胺75 mg/m^(2),每日1次口服。观察组在放化疗基础上辅助采用微波热疗。两组患者均在治疗前和治疗8周后采用SAS、SDS量表评估两组患者焦虑、抑郁状况,采用PSQI问卷评估两组患者睡眠状况;采用自制问卷评估两组患者治疗依从性及治疗满意度的差异;比较两组患者治疗期间肌酐、甘露醇、甘油果糖、激素、利尿剂及外周静脉血管受损方面的差异。结果 观察组在焦虑、抑郁、睡眠方面优于对照组,差异具有统计学意义(P<0.05);观察组治疗满意度(86.96%vs 58.88%)、治疗依从性(80.43%vs 61.76%)高于对照组,外周静脉血管受损情况优于对照组(26.09%vs 94.12%),观察组治疗期间肌酐值低于对照组,差异有统计学意义(P<0.05)。甘油果糖使用天数少于对照组,但差异无统计学意义(P>0.05);甘露醇、激素、利尿剂使用天数少于对照组,差异具有统计学意义(P<0.05)。结论 微波热疗能够减轻脑胶质瘤患者的缓解焦虑、抑郁情绪,改善患者的睡眠状况,减少患者甘露醇、利尿剂、激素的使用率,可以保护肾功能、外周血管且可提升治疗依从性及治疗满意度,值得临床推广。

Objective To investigate the effects of microwave hyperthermia assisted chemoradiotherapy on short-term efficacy,improvement of symptoms associated with chemoradiotherapy,treatment compliance and satisfaction in patients with glioma.Methods A total of 80 patients with brain glioma were selected from the Department of Radiotherapy,the First Afiliated Hospital of Zhengzhou University from June 2022 to March 2024,with 46 cases in the observation group and 34 cases in the control group.The control group was treated with radiotherapy and chemotherapy according to NCCN guidelines.Volumetric arc-shaped intensity modulated radiotherapy(VMAT)was used for radiotherapy,with a total dose of 50~60G yand 1.8~2.00 Gy/time.Chemotherapy was administered with temozolomide 75mg/m^(2)orally once a day.The observation group received microwave hyperthermia on the basis of chemoradiotherapy.Before and 8 weeks after treatment,SAS and SDS scales were used to evaluate the anxiety and depression status of patients in both groups,and PSQI questionnaire was used to evaluate the sleep status of patients in both groups.The differences of treatment compliance and satisfaction between the two groups were evaluated by self-made questionnaire.The differences of creatinine,mannitol,glycerol fructose,hormones,diuretics and peripheral venous vessel damage were compared between the two groups during treatment.Results The observation group was superior to the control group in anxiety,depression and sleep,and the difference was statistically significant(P<0.05).Treatment satisfaction(86.96%vs 58.88%)and treatment compliance(80.43%vs 61.76%)in the observation group were higher than those in the control group,and peripheral venous vessel damage was better than that in the control group(26.09%vs 94.12%,P<0.05).During treatment,the creatinine value of observation group was lower than that of control group,and the days of glycerin fructose use were less than that of control group,but the difference was not statistically significant(P>0.05).The use days of mannitol,hormone and diuretic were less than those in the control group,(P<0.05).Conclusion Microwave hyperthermia can relieve anxiety and depression in patients with glioma,improve their sleep status,reduce the utilization rate of mannitol,diuretic and hormones,protect renal function and peripheral blood vessels,and improve treatment compliance and treatment satisfaction,which is worthy of clinical promotion.