神经胶质瘤术后放疗同步替莫唑胺化疗的临床疗效及安全性评估  

Clinical Efficacy and Safety of Radiotherapy Combined with Temozolomide Chemotherapy for Postoperative Glioma

作　　者：王雷[1] 魏盾[1] 孟凡斌[2] 邱冬冬[2] 沈维高[1] 

机构地区：[1]北华大学附属医院,吉林吉林132011 [2]北华大学基础医学院,吉林吉林132013

出　　处：《北华大学学报（自然科学版）》2014年第6期762-765,共4页Journal of Beihua University（Natural Science）

基　　金：吉林省教育厅科学技术研究项目(2012150);吉林省科技发展计划项目(201215100)

摘　　要：目的分析神经胶质瘤患者术后放疗同步替莫唑胺(Temozolomide,TMZ)化疗的临床疗效及其安全性.方法将收治的86例神经胶质瘤术后患者随机分为两组.A组(43例)采用三维适形放疗同步TMZ化疗,B组(43例)采用单纯三维适形放疗,所有治疗均在术后1个月内开始.比较两组患者的临床疗效、术后1,2,3 a的生存率、Karnofsky评分及毒副作用.结果 A组的客观有效率(Objective response rate,ORR)和疾病控制率(disease control rate,DCR)分别为76.7%和90.7%,显著高于B组(55.8%和74.4%)(P<0.05);治疗后,两组Karnofsky评分均较治疗前有所提高,且A组显著高于B组(P<0.05);术后中位生存期及术后1,2,3 a的生存率A组均显著高于B组(P<0.05);两组治疗期间的毒副作用比较无统计学意义(P>0.05).结论放疗同步TMZ化疗是神经胶质瘤术后一种安全、有效的辅助治疗方法,可提高近远期疗效和术后的生存率,且并不增加药物毒性作用.Objective To explore the clinical efficacy and safety of radiotherapy combined with temozolomide （ TMZ ） chemotherapy for postoperative glioma. Method Eighty-six patients with postoperative glioma were randomly divided into two groups, namely, group A （ n=43 ） and group B （ n=43 ） . Patients in group A were treated with three-dimensional conformal radiotherapy combined with TMZ,and those in group B were treated with three-dimensional conformal radiotherapy only. After the treatment for 1 month,the effective rate,1-year,2-year and 3-year survival rates,Karnofsky scores,and toxic and side effects of patients in two groups were compared. Results ORR（ Objective response rate ） and DCR （ disease control rate ） in group A （ 76. 7% and 90. 7%respectively）were significantly higher than those in group B（55. 8% and 74. 4% respectively） （P〈0. 05）. Karnofsky scores increased in both groups after the treatment,and the increase degree was significantly higher in group A than that in group B（P〈0. 05）. The median survival time,1-year,2-year and 3-year survival rates after the operation in group A were significantly higher than those in group B （ P〈0 . 05 ） . There was no significant difference in the toxic and side effects between the two groups （ P〉0 . 05 ） . Conclusions The radiotherapy combined with TMZ chemotherapy is an effective and well-tolerable auxiliary therapy for postoperative glioma. It can improve the short-term and long-term effect,and the survival rate of the patients without increasing toxic and side effects of drug.

关 键 词：神经胶质瘤 放疗 化疗 替莫唑胺 

分 类 号：R739.4[医药卫生—肿瘤]