替莫唑胺联合放疗治疗脑转移瘤的疗效评价

Evaluation of the Efficacy of Radiotherapy Concurrent Temozolomide Chemotherapy in Brain Metastases Patients

目的:探讨替莫唑胺联合放疗治疗脑转移瘤的临床疗效。方法:选择我院放疗科住院的脑转移瘤患者60例,随机分为两组:单纯放疗组(包括全脑放射治疗+立体定向放射治疗,A组)、替莫唑胺联合放疗组(B组)每组30例。采用WHO实体瘤评价标准比较两组的临床疗效,并计算有效率和疾病控制率;同时比较两组不良反应(头痛、恶心、呕吐、骨髓抑制、肝功能损害、肾功能损害等)的发生率和死亡率。结果:(1)两组患者年龄、体重、身高、性别比以及原发肺癌病理类型的比较均无显著差异(P>0.05);(2)B组治疗后完全缓解率、治疗有效率、疾病控制率均比A组明显改善(P<0.05),1年死亡病例也比A组明显减少(P<0.05);(3)B组治疗期间恶心呕吐、骨髓抑制的发生率均比A组明显增高(P<0.05),经对症治疗后均好转;两组在头痛、肝功能损害和肾功能损害方面比较均无明显差异(P>0.05)。结论:应用替莫唑胺联合放疗在脑转移瘤中具有良好的临床疗效,值得临床推广。

Objective :To investigate the the efficacy of radiotherapy concurrent Temozolomide chemotherapy in Brain metastases patients .Methods :Sixty Brain metastases patients were selected and divided into 2 groups each group with 30 patients :A group was treated by radiotherapy alone ,including whole brain radiotherapy (WBRT) and stereotatic radiotherapy (SRT) ,and B group was treated by radiotherapy concurrent Temozolomide chemotherapy .The clinical ef‐ficacy was evaluated by WHO solid tumors using clinical efficacy evaluation criteria ,and efficiency and disease control rate were calculated .The complication during the therapy including headache ,nausea and vomiting ,bone marrow sup‐pression ,liver damage ,kidney damage ,mortality were compared .Results:(1)There were no significant differences of age ,weight ,sex ratio and pathological type of the primary tumor between the 2 groups (P>0 .05) .(2)Compared with A group ,the complete remission rate (CR) ,response rate (RR) ,disease control rate (DCR) were significantly higher than those in A group (P<0 .05) ,and the rate of mortality in 1 year deaths was significantly lower in A group (P<0.05) .(3)The incidences of nausea and vomiting and bone marrow suppression were much higher in B group than those in A group(P<0 .05) ,which were improved after appropriate treatment .There were no significant differences of head‐aches ,liver and renal damage showed no significant difference between the 2 groups (P>0 .05) .Conclusion:Radiother‐apy concurrent Temozolomide chemotherapy was safe and efficient in Brain metastases patients and worthy of clinical application .