放疗同步替莫唑胺化疗治疗恶性胶质瘤临床观察  

Effect of radiotherapy plus concomitant and adjuvant temozolomide on malignant glioma

作　　者：狄淬砺[1] 马晓东[1] 许百男[1] 余新光[1] 李方晔[1] 张义鹏[1] 王同力[1] 

机构地区：[1]解放军总医院神经外科,北京100853

出　　处：《军医进修学院学报》2010年第6期551-552,554,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的研究术后放疗同步替莫唑胺(RT-TMZ)治疗恶性胶质瘤的近期疗效和不良反应。方法收集2008年11月-2009年5月在我院确诊的61例恶性胶质瘤术后患者,按照患者自愿选择的治疗方案分为RT-TMZ组和单纯放疗(RT)组。RT-TMZ组31例,行放疗(总剂量60Gy,共治疗6周)期间同时持续口服替莫唑胺(Temozolomide,TMZ)化疗(75mg/(m2·d),共42d),放疗结束后续行TMZ辅助化疗150-200mg/(m2·d),共4-6个周期;RT组30例,单纯放疗6周,总剂量60Gy。结果RT-TMZ组与RT组有效率(CR+PR)分别为79.3%(23/29)、53.3%(16/30),疾病控制率(CR+PR+SD)分别为89.7%(26/29)、83.3%(25/30),P<0.05。RT-TMZ组6个月无疾病进展生存率为71.0%(22/31),患者对治疗的耐受性良好;不良反应为恶心、呕吐和乏力,白细胞和血小板下降基本限于I-Ⅱ度。结论恶性胶质瘤术后放疗同步替莫唑胺治疗近期疗效良好,不良反应较轻,是切实可行的治疗方案。Objective To study the effect of temozolomide combined with radiotherapy（RT-TMZ）on malignant glioma after operation and its toxic side effects.Methods Sixty-one patients with malignant glioma admitted to our hospital in November 2008-May 2009 were divided into RT-TMZ group（n=31）and RT group（n=30）.Patients in RT-TMZ group received radiotherapy with a total dosage of 60Gy and chemotherapy with oral temozolomide（TMZ）,75mg/（m^2·d）for 42 days,followed by 4-6 cycles of adjuvant TMZ,150-200mg/（m^2·d）.Patients in RT group received only radiotherapy with a total dosage of 60Gy for 42 days.Results The response rate was 79.3%（23/29）and 53.3%（16/30）respectively in RT-TMZ group and RT group.The disease control rate was 89.7%（26/29）and 83.3%（25/30）respectively in the two groups.The 6-month survival rate was 71.0%（22/31）in RT-TMZ group with no disease progress.The patients had a rather good tolerance to radiotherapy and chemotherapy.The main side effects included nausea,vomiting,and anorexia.The number of white blood cells and platelets was decreased.Conclusion Radiotherapy plus concomitant and adjuvant temozolomide has a rather good short-term efficacy on malignant glioma with less side effects and is a practical treatment modality for malignant glioma.

关 键 词：神经胶质瘤 放射疗法 替莫唑胺 

分 类 号：R651[医药卫生—外科学]