109例脑恶性胶质瘤患者术后联合放射治疗的临床疗效分析  

Clinical curative effect analysis of 109 cases of patients with brain malignant gliomas treated with operation combined with postoperative radiotherapy

作　　者：刘梁[1] 戈伟[1] 罗顺祥[1] 唐甜[1] 丁万军[1] 

机构地区：[1]武汉大学人民医院肿瘤Ⅱ科,湖北武汉430060

出　　处：《中国医药导报》2012年第30期38-40,共3页China Medical Herald

基　　金：国家自然科学基金项目(项目编号:30970860);中华国际医学交流基金会"先声抗肿瘤治疗专项科研基金"专项基金项目(项目编号:CIMF-F-H001-001)

摘　　要：目的观察脑胶质瘤患者术后进一步联合三维适形放疗等综合治疗方式的疗效和安全性。方法回顾性分析我院109例术后联合放射治疗等多种治疗方式的脑恶性胶质细胞瘤患者的病历资料,对近期疗效和不良反应进行评价,随访时间12～36个月,中位随访时间13个月,计算患者1～3年生存率。结果 109例脑恶性胶质细胞瘤患者均按计划完成治疗,1个月后返院MRI复查结果提示:完全缓解(CR)75例,部分缓解(PR)14例,稳定(SD)13例,疾病进展(PD)7例,客观有效率(RR)为81.6%,疾病探制率(DCR)为93.6%。中位无疾病进展时间(TTP)为14个月,放化疗过程主要毒性表现在脑组织水肿、消化道和骨髓造血功能的抑制等方面。34例患者经MRI检查证实发生放射性脑水肿,发生几率为31.2%。结论精确的肿瘤切除术后及时的放疗对控制术后残留病灶,完全阻断肿瘤生长根源有重要意义,如能同时接受正规的化疗以及特异性的靶向药物治疗,可收到较好的效果,是目前首选的综合治疗方式。Objective To observe the efficacy and safety of comprehensive therapy with operation combined with three-dimensional conformal radiotherapy in treating brain malignant gliomas patients.Methods The medical records of 109 cases of brain malignant gliomas,who were treated with combining therapy with operation combined with postoperative radiotherapy were analyzed retrospectively to evaluate their short-term effects and adverse reaction.All the patients were followed up for 12-36 months to calculate their one to three years survival rate,and the median follow-up time was 13 months.Results All the 109 cases of brain malignant gliomas patients were accomplished the therapy on schedule,the MRI review results after a month indicate： CR in 75 cases,PR in 14 cases,SD in 13 cases,PD in 7 cases.RR accounts for 81.6%,DCR accounts for 93.6%.The median TTP was 14 months.The toxic actions of radiotherapy and chemotherapy were found in brain edema,gastrointestinal reactions and bone marrow hematopoietic function suppression.And 34 patients were confirmed radioactive cerebral edema by MRI,the incidence rate was 31.2%.Conclusion It is an important significance to use radiotherapy timely after accurate tumor resection for the control of postoperative residual lesions and the completely blocking of tumor growth.It will get better result if they receive formal chemotherapy and specific targeted drugs therapy at the same time,and it is the preferred comprehensive therapy.

关 键 词：三维适形放疗 胶质细胞瘤 替莫唑胺 分子靶向治疗 

分 类 号：R739.41[医药卫生—肿瘤]