调强适形放疗联合替莫唑胺治疗恶性脑胶质瘤的临床观察  

Clinical Effect of Intensity Modulated Radiation Therapy Combined with Concomitant and Adjuvant Temozolomide in the Treatment for Malignant Glioma

作　　者：姚春筱[1] 张树平[1] 陈保民[1] 崔淑敏[1] 王玉瑛[1] 

机构地区：[1]山西省人民医院,山西太原030012

出　　处：《中国肿瘤》2013年第3期238-240,共3页China Cancer

摘　　要：[目的]观察调强适形放疗(IMRT)联合替莫唑胺(TMZ)治疗恶性脑胶质瘤的临床疗效。[方法]28例术后病理诊断为高级别胶质瘤(WHOⅢ～Ⅳ)的患者,术后放射治疗为全脑左、右对穿野常规照射(WBRT)并后程调强加量照射。常规放射治疗剂量为40Gy/20f/4w,调强放射治疗剂量为20Gy/4f/2w;放疗同步口服替莫唑胺(TMZ)治疗6个周期,之后再接受至少2个周期的常规TMZ治疗。[结果]中位生存时间及无进展生存时间分别为11.5个月和7.2个月;1年总生存率为53.57%,2年总生存率为25.00%。常见的不良反应为恶心、呕吐,血液学毒性是白细胞和血小板下降,但仅限于Ⅰ～Ⅱ度。[结论]IMRT同步TMZ治疗恶性脑胶质瘤,安全有效,不良反应轻微。[Purpose] To investigate clinical efficacy of intensity modulated radiation therapy （IMRT） combined with concomitant and adjuvant temozolomide （TMZ） in the treatment for malignant glioma. [Methods] A total of 28 malignant glioma cases （grade Ⅲ～Ⅳ） pathologically proved were enrolled.After 40Gy/20f/4w by conventional fractionation irradiation delivered through whole brain left/right fields, IMRT was started as a boost.The irradiation dose of doseescalation was 20Gy/4f/2w; TMZ was given for 6 cycles at the same time,then at least 2 cycles by the routine treatment. [Results ] The median survival time and the progression free survival time were 11.5 months and 7.2 months respectively. I- year and 2- year survival rate were 53.57% and 25.00% respectively.The common side effects were nausea,vomiting; hematologic toxicity was white cells and platelets decreased（degree Ⅰ～Ⅱ ）. [Conclusion] IMRT plus concomitant and adjuvant TMZ for malignant glioma is safe and effective,with mild adverse reactions.

关 键 词：恶性胶质瘤 调强适形放疗 替莫唑胺 

分 类 号：R739.41[医药卫生—肿瘤]