螺旋断层放射治疗联合替莫唑胺治疗脑胶质母细胞瘤的疗效分析  

The Efficacy Analysis of Helical Tomotherapy Combined with Temozolomide Chemotherapy Treatments on Patients of Postoperative Glioblastoma

作　　者：徐莹[1] 郭占文[1] 柳云恩[2] 阎英[1] 

机构地区：[1]沈阳军区总医院放射治疗科,沈阳110840 [2]沈阳军区总医院急诊医学部.全军重症(战)创伤急救中心实验室,沈阳110840

出　　处：《成都医学院学报》2014年第5期565-568,共4页Journal of Chengdu Medical College

基　　金：辽宁省科技攻关课题资助(NO:2012225008)

摘　　要：目的对恶性脑胶质瘤术后螺旋断层放射治疗联合口服化疗药物替莫唑胺（TMZ）的疗效进行分析。方法收集2011年10月-2012年8月就诊于沈阳军区总医院的23例脑胶质母细胞瘤术后患者的相关信息,所有患者均应用螺旋断层放射治疗技术调强放射治疗,同步给予替莫唑胺胶囊化疗,其中13例继续服用替莫唑胺胶囊辅助化疗6个周期,5例辅助化疗〉6个周期,5例仅同步放化疗未辅助化疗。23例平均随访14个月,对治疗的疗效、不同影响因素与恶性胶质瘤预后的影响和治疗的相关副反应进行分析。结果患者中位总生存期（OS）为17.2个月,中位无疾病进展生存期（PFS）为8.6个月,其中KPS评分较高（〉80）患者的PFS明显延长;辅助化疗≥6个周期患者的PFS和OS明显延长;手术至放疗时间〈4个周期患者的OS明显延长。所有患者均未出现Ⅲ-Ⅳ级毒副反应,耐受性良好。结论应用螺旋断层放疗技术同步放化疗治疗胶质母细胞瘤安全、有效,具有可行性,为临床治疗提供了新的方向。Objective To explore the efficacy of tomotherapy combined with oral chemotherapy drug temozoiomide（TMZ）on postoperative glioblastoma patients.Methods 23 adult patients diagnosed as postoperative glioblastoma were collected in our department from October 2011 to August 2012.They were all treated with tomotherapy using with temozoiomide synchronously,whom of 13 continued to used the oral Temozolomide as the adjuvant chemotherapy for 6cycles,5used the chemotherapy for over 6cycles and 5just received concurrent chemoradiotherapy without any adjuvant chemotherapy.Results In a follow-up for 14 months,the efficacy,different effect facters impacting the spongioblastoma and the relative reaction of the efficacy in the 23 cases were analyzed we had found that the median overall survival（OS）was 17.2months,the median progression-free survival（PFS）was 8.6months.In Karnofsky score（KPS）higher（〉80）,the PFS was obviously extended;adjuvant chemotherapy with more than or equal to 6cycles could prolong the patients＇ PFS and OS;When the interval between operation and radiotherapy was less than 4weeks,the patients＇ OS was significantly prolonged.Toxicity of grade III-IV was not seen in all the patients,and they were all well tolerated.Conclusion The efficacy of using helical tomotherapy technology combined with concurrent chemo-radiotherapy is safe,effective and feasible.What＇s more,it provides a new direction for our future clinical treatment.

关 键 词：替莫唑胺 螺旋断层放射治疗 脑胶质母细胞瘤 疗效 

分 类 号：R739.41[医药卫生—肿瘤]