替莫唑胺化疗联合放疗对弥漫性内生型脑干胶质瘤临床疗效及预后分析  

Study on clinical effect of combined temozolomide chemotherapy with radiotherapy in treatment of patients with diffuse endogenous glioma in brain stem and their prognosis

作　　者：权俊杰[1] 周乐[1] 付海燕[1] 陆玮[1] 屈建强[1] 

机构地区：[1]西安交通大学第二附属医院神经外科,陕西西安710004

出　　处：《临床和实验医学杂志》2015年第4期310-313,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨替莫唑胺化疗联合放疗对弥漫性内生型脑干胶质瘤(DBSG)临床疗效,并对影响预后的因素进行分析。方法将2008年2月至2011年8月本院收治的DBSG患者64例随机分为两组,对照组(32例)采用单纯放疗治疗,实验组(32例)采用替莫唑胺化疗联合放疗治疗。随访观察两组患者短期疗效、生存率和不良反应,并对影响预后的因素进行Log-Rank分析。结果 1实验组治疗有效率68.75%明显高于对照组(40.62%),两组比较差异具有统计学意义(Ridit z=19.232,P<0.05);2两组生存率比较,1年生存率差异无统计学意义(P>0.05);实验组2年、3年生存率均显著高于对照组(P<0.05),且中位复发时间高于对照组(P<0.05);3两组患者不良反应白细胞减少、头痛、呕吐、癫痫及智力下降发生率差异均无统计学意义(P>0.05);4对影响预后的因素进行分析发现,性别、治疗前症状持续时间、Karnofsky评分和组别对生存率影响差异具有统计学意义(P<0.05),低龄、治疗前症状持续时间≥2月、Karnofsky评分<70分和仅采用放疗治疗是影响预后的危险因素。结论替莫唑胺能够改善DBSG患者短期疗效,提高2年、3年生存率,且不增加患者不良反应,值得临床推广应用。且年龄≥65岁、治疗前症状持续时间<2月、Karnofsky评分≥70分患者,有必要采取替莫唑胺联合放疗治疗,以改善患者症状,提供远期生存率。Objective To explore the clinical effect of combined temozolomide chemotherapy with radiotherapy in treatment of patients with diffuse endogenous glioma in brain stem,and to analyze factors affecting the prognosis with Log-Rank analysis.Methods A total of 64 patients with DBSG during February 2008 to August 2011 in this hospital were randomly divided into 2 groups,patients in control group（ 32 cases）were treated by radiotherapy,patients in trial group（ 32 cases） were administrated with combined temozolomide chemotherapy and radiotherapy,their short-term curative effect,survival rate and adverse reactions were observed and followed-up,and factors affecting the prognosis were analyzed with Log-Rank analysis.Results 1 The effective rate of trial group was 68.75%,while it in control group was 40.62%,there was significant difference between these two groups（ Ridit z = 19.232,P0.05）.2 There was no significant difference in 1 year survival rate between two groups（ P0.05）,but difference in 2 years and 3 years survival rates was statistically significant（ P0.05）,the median duration for relapse in trial group was higher than that of control group（ P0.05）.3 The difference in adverse reactions including leukopenia,headache,vomiting,seizure and mental decline in these two groups was not statistically significant（ P0.05）.4 The factors affecting the prognosis were analyzed and it had been found that sex,difference in duration of symptoms,Karnofsky scores and grouping had significant influence on survival rate（ P0.05）,younger in age,duration of symptoms before treatment ≥ 2 months,Karnofsky scores70 and simple radiotherapy were dangerous prognostic factors.Conclusion Temozolomide can improve the short-term efficacy in patients with DBSG,increase the survival rates of 2years and 3 years,and it does not increase the adverse reactions of patients,hence it is worthy to be clinically applied.Patients with age ≥65years old,the duration of symptoms before treatment less than 2 months and Karnofsky sc

关 键 词：弥漫性内生型脑干胶质瘤 替莫唑胺 放疗 疗效 

分 类 号：R739.41[医药卫生—肿瘤]