放射治疗联合替莫唑胺治疗脑转移瘤的疗效分析  

Radiotherapy plus concomitant and adjuvant temozolomide for brain metastatic tumor

作　　者：韦燕[1] 赵善琳[1] 易海振 曾俊韶[1] 

机构地区：[1]广西医科大学附属第八医院(贵港市人民医院)肿瘤科,广西贵港537100

出　　处：《现代肿瘤医学》2015年第15期2114-2116,共3页Journal of Modern Oncology

基　　金：贵港市科学研究与技术开发计划项目(编号:贵科攻1305016)

摘　　要：目的:观察放射治疗联合替莫唑胺治疗脑转移瘤患者的疗效。方法:将62名脑转移瘤患者随机分为放疗组和放疗联合替莫唑胺组。其中放疗组给予全脑照射,采用6MV-X线常规照射,2Gy/次,5次/周,共4周,总量40Gy,全脑放疗后,只对最大的2个病灶缩野加量至50-56Gy。放疗联合替莫唑胺组中,放射治疗方法同放疗组,并在放疗的整个疗程中同步口服替莫唑胺75mg/m2化疗至放疗结束。放疗结束后4周,继续使用替莫唑胺化疗,其中第1周期给量150mg/m2,连续用药5天,28天为一个疗程,若患者耐受良好,在以后化疗疗程中增量至200mg/m2,替莫唑胺推荐化疗6个周期。结果:放疗联合替莫唑胺组的有效率为83.9%,高于放疗组的71.0%(P>0.05)。中位生存期和1年生存率分别为14个月和58.1%,均高于放疗组的10个月和32.3%(P<0.05)。放疗联合替莫唑胺组的疾病控制率为93.6%,优于放疗组的90.3%。两组患者均未出现严重的不良反应。结论:替莫唑胺联合放疗在脑转移瘤的治疗中有较好的疗效和安全性。Objective： To observe the efficacy of temozolomide combined with radiotherapy for patients with brain metastasis. Methods： All 62 patients with brain metastasis were divided into temozolomide combined with radiotherapy group and radiotherapy group randomly. Radiotherapy group was given atotal dose of 40 Gy,2Gy / t,5d / week of whole brain reirradiation. Extra dose of 50-56 Gy with 3D-CRT technology would add to the 2 of the biggest nidus without incomplete regression after accepting dose of 40 Gy. Patients in temozolomide combined with radiotherapy group received irradiation at the same dose plus concomitant daily temozolomide administered orally at a dose of 75 mg / m2,and completion of radiation therapy took 150 mg /（ m2·d） at first cycle（ 5 days every 28 days for one cycles）,200 mg /（ m2·d） at second to the sixth cycles. Results： The efficiency rate of temozolomide combined with radiotherapy group was 83. 9% and the radiotherapy group was 71. 0%（ P〉 0. 05）,mean survival time,one-year survival rate and disease control rate in temozolomide combined with radiotherapy group was 14 months,58. 1% and 93. 6%,significantly higher than that in radiotherapy group（ P〈 0. 05）. No significant adverse reactions appeared in two groups.Conclusion： Radiotherapy plus temozolomide for the treatment of patients with brain metastasis is effective and safe.

关 键 词：替莫唑胺 放射治疗 脑转移瘤 

分 类 号：R730.5[医药卫生—肿瘤]