胶质母细胞瘤术后同步放化疗临床疗效观察  

Clinical efficacy of temozolomide concomitant radiotherapy and chemoradiotherapy for post-operative glioblastoma

作　　者：周卫兵[1] 汪洁[1] 张莹莹[1] 廖遇平[1] 

机构地区：[1]中南大学湘雅医院肿瘤科,湖南长沙410008

出　　处：《中国现代医学杂志》2010年第8期1203-1206,共4页China Journal of Modern Medicine

基　　金：湖南省科学技术厅社会发展科技处资助项目(No:2009SK3182)

摘　　要：目的观察胶质母细胞瘤术后,替莫唑胺（TMZ）同步放化疗的临床疗效。方法 2006年4月~2007年4月收治55例手术后病理证实为胶质母细胞瘤的病人,随机分为2组：①辅助化疗组（30例）,术后放疗后予TMZ辅助化疗,第1周期化疗[150 mg/（m2.d）,d1~5,间隔28d];第2~4周期[200 mg/（m2.d）,d1~5],间隔28 d）;②同步放化疗组（25例）,放疗开始便予TMZ第一周期化疗（[150 mg/（m2.d）,d1~5）],放疗28 d时予TMZ第2周期化疗（[200 mg/（m2.d）,d1~5）],以后再予TMZ辅助化疗2周期。术后放疗剂量均为DT60Gy/30次。随访至2009年4月,观察总生存时间、无进展生存时间以及毒副反应。结果辅助化疗组的中位生存时间为7.6月,同步放化疗组的中位生存时间为13.8月。中位无进展生存时间分别为：4.25月和6.65月。2年总生存率分别为：13.33%和24%（P=0.0420）。2年无进展生存率分别为：10%和16%（P=0.0231）。差别均有统计学意义。且没有发现明显毒副反应。结论胶质母细胞瘤术后予TMZ同步放化疗疗效优于术后放疗后辅助化疗,且病人能很好的耐受。【Objective】To study the clinical efficacy of concomitant temozolomide（TMZ）chemotherapy and radiotherapy in patients with post-operative glioblastoma.【Methods】Fifty-five post-operative patients with pathologically confirmed glioblastoma（from April,2006 to April,2007） were randomly assigned to 2 groups： the adjuvant group（n =30） ： patients received radiotherapy and adjuvant temozolomide（the first cycle： 150 mg/m2/d for 5 days,and the second to the fourth cycle： 200 mg/m2/d for 5 days with interval of 28 days;the concomitant group（n =25）： patients received radiotherapy plus concomitant temozolomide,the first cycle was from the first day of radiotherapy（150 mg/m2/d,d 1-5）,and the second cycle was from the 28th day of radiotherapy（200 mg/m2/d,d 1-5）,followed by two cycles of adjuvant temozolomide（200 mg/m2/d for 5 days during each 28-day）.The patients were followed up until April,2009 for observation of progression-free survival,overall survival and safety.【Results】The median survival durations of the first group and the second group were 7.6 months and 13.8 months.The median progression-free survival durations of the first group and the second group were 4.25 months and 6.65 months respectively.The two-year survival rates of the first group and the second group were 13.33% and 24%.The two-year progression-free survival rates were 10% and 16%（P =0.0231）.Only 2 patients experienced leucopenia of 1 degree and 3 patients experienced leucopenia of 2 degree,and there was no abnormality in hepatic and renal function.【Conclusion】Concomitant administration of temozolomide to radiotherapy in patients with post-operative glioblastoma seems to be more effective than the administration of temozolomide adjuvant to radiotherapy,and concomitant administration of temozolomide is well tolerated.However,further study is needed to research the patients who will benefit most from TMZ,the best usage and doses of TMZ,the interaction of TMZ with other drugs,and also how this intera

关 键 词：胶质母细胞瘤 替莫唑胺 同步放化疗 

分 类 号：R739.41[医药卫生—肿瘤]