高度恶性脑胶质瘤放疗联合替莫唑胺(国产)化疗临床研究  

Concurrent TMZ Chemotherapy with Radiotherapy for High Grade Glioma

作　　者：李方明[1] 聂青[1] 徐世侠[2] 杨平[1] 于新[3] 康静波[1] 张丽萍[1] 张军[1] 

机构地区：[1]海军总医院放射治疗科,北京100048 [2]海军总医院信息科,北京100048 [3]海军总医院神经外科,北京100048

出　　处：《海军总医院学报》2009年第1期6-9,共4页Journal of Naval General Hospital of PLA

摘　　要：目的探讨采用国产化疗新药替莫唑胺与现代立体定向适形放疗综合治疗高度恶性胶质瘤的疗效和安全性。方法37例高度恶性胶质瘤均经病理确诊,其中Ⅲ级18例、Ⅳ级19例。按治疗方法将其分为两组,A组:放疗合并替莫唑胺同步化疗22例(Ⅲ级11例、Ⅳ级11例);B组:单放疗15例(Ⅲ级7例、Ⅳ级8例)。放疗合并同步替莫唑胺化疗[75 mg/(m2.d)]6周,放疗后替莫唑胺序贯/辅助化疗[150～200mg/(m2.d)]2～4周期。立体定向适形放疗1.8～3 Gy/d,部分患者采用超分割放疗,总剂量60～75 Gy。Kaplan-meier方法计算生存率,Logrank法显著性检验。结果A组和B组1、2年生存率分别为64.8%、40%和53.3%、26.7%。两组比较统计学有非常显著性差异(P=0.002)。提示放疗+替莫唑胺化疗联合治疗较单放疗可明显提高高度恶性胶质瘤的生存率,未观察到明显的毒副作用。结论初步结果表明:高度恶性胶质瘤术后放疗联合替莫唑胺(国产)化疗可显著提高患者生存率。患者对国产替莫唑胺化疗合并放疗耐受性良好,值得进一步深入研究。Objective To evaluate the results of postoperative concurrent Temozolomide （TMZ）ehemotherapy with radiotherapy for high grade glioma（HGG）. Methods Thirty-seven patients with HGG were treated from Apr. 2004 to Oct. 2007. Twenty-two patients（11 of grage Ⅲ and 11 grade Ⅳ） were treated by concurrent TMZ Chemoradiotherapy with radiotherapy（A group）,and fiveteen patients（7 of grage Ⅲ and 8 of grade Ⅳ） were treated by radiotherapy along （B group）. A group received concurrent TMZ chemoradiotherapy （75 mg/m^2 · d） for 6 weeks. Sequential TMZ chemotherapy （150-200 mg/m^2 · d） after the radiotherapy was carried out for 2-4 weeks. Sereotactic eonformal radiotherapy was deli- vered by 6 MV/10 MV-X, and patients received overall DT 60- 75 Gy. Hyperfraetionated radiotherapy of 1.8-3 Gy/day were delivered,5 day/week. Results One and two years survival rates in A and B groups were 64.8% and 53.3%;40% and 26.7%,respectively. There was a significance difference between the concurrent TMZ chemotherapy with radiotherapy group and radiotherapy along group（P=0. 002）. This results showed that concurrent TMZ chemotherapy with radiotherapy increased survival times. Conclusions Concurrent TMZ chemotherapy with radiotherapy is much better than the radiotherapy along for HGG. It is worthy of clinical application.

关 键 词：高度恶性脑胶质瘤 三维立体适形放疗 替莫唑胺 

分 类 号：R739.41[医药卫生—肿瘤]