调强适形放射治疗联合替莫唑胺化疗治疗恶性脑胶质瘤的近期疗效及安全性评价  

Evaluation of short-term efficacy and safety of intensity modulated radiation therapy plus concomitant and adjuvant temozolomide in patients with malignant gliomas

作　　者：张玉宇[1] 曲雅勤[1] 姜新[1] 赵钦[1] 郭潇[1] 冯奇[2] 

机构地区：[1]吉林大学第一医院肿瘤中心放疗科,吉林长春130021 [2]吉林大学第二医院放疗科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2012年第3期571-574,共4页Journal of Jilin University：Medicine Edition

基　　金：吉林省发展与改革委员会科研基金资助课题(2010019-1)

摘　　要：目的:探讨调强适形放射治疗(IMRT)联合替莫唑胺(TMZ)化疗治疗恶性脑胶质瘤的近期疗效和安全性,为临床治疗方案的选择提供依据。方法:选择经手术病理确诊的恶性脑胶质瘤术后患者46例,随机分为联合治疗组(IMRT+TMZ)22例和单纯放疗组(IMRT)24例,随访12～31个月,中位随访时间为19个月,观察2组患者中位无进展生存期、1年生存率及不良反应发生率。结果:全部患者均按计划进行治疗,联合治疗组和单纯放疗组的中位无进展生存期为10个月和7.6个月(P<0.05),1年生存率为86.36%(19/22)和58.33%(14/24),2组患者1年生存率比较差异有统计学意义(P<0.05);2组患者的不良反应均为Ⅰ～Ⅱ度的骨髓抑制和消化道反应,患者可较好耐受,2组患者不良反应发生率差异无统计学意义(P>0.05)。结论:IMRT联合TMZ化疗治疗恶性脑胶质瘤的近期疗效明显优于单纯IMRT,且不良反应轻微,是安全有效的综合治疗方案。Objective To evaluate the short-term efficacy and safety of intensity modulated radiation therapy（IMRT） plus concomitant and adjuvant temozolomide（TMZ） in patients with malignant gliomas and to provide basis for selection of clinical therapy program.Methods Forty-six postoperative patients with malignant gliomas confirmed by pathology were randomly divided into combined therapy group（n=22,IMRT＋TMZ） and radiotherapy group（n=24,IMRT alone）.All the patients were followed up for 12-31 months,and the median follow-up time was 19 months.The median progression-free survival,1-year survival rate and the incidence of adverse reactions were observed.Results All the patients were carried out according to the plan.The median progression-free survival was 10 months in combined therapy group and 7.6 months in radiotherapy group;the 1-year survival rates were 86.36% and 58.33%（P〈0.05）,respectively.The main adverse reactions in two groups were myelosuppression and gastrointestinal reactions of gradeⅠ-Ⅱ,there was no significant difference between two groups（P〉0.05）,and the patients could tolerate well.Conclusion The combination of IMRT and TMZ can achieve much better short-term efficacy than IMRT alone,and the adverse reactions are little,which is a safe and effective method for postoperative maglignant glioma.

关 键 词：恶性脑胶质瘤 调强适形放疗射治 替莫唑胺 无进展生存期 1年生存率 安全性 

分 类 号：R739.41[医药卫生—肿瘤]