老年多形性胶质母细胞瘤术后替莫唑胺同步放疗临床观察  

Clinical observation of curative effect and adverse reaction of postoperative synchronous intensity modulated radiation therapy combined with temozolomide for the elderly glioblastoma multiforme

作　　者：孙涛[1] 董莹[1] 张矛[1] 

机构地区：[1]吉林省肿瘤医院放疗三科,吉林长春130012

出　　处：《中华肿瘤防治杂志》2015年第18期1466-1469,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的观察替莫唑胺联合调强放疗治疗老年多形性脑胶质母细胞瘤的临床疗效和安全性。方法对吉林省肿瘤医院2009-05-01-2013-05-31收治的58例老年多形性脑胶质母细胞瘤术后患者的临床资料进行回顾性分析,按治疗方式分为观察组(n=34)和对照组(n=24)。对照组患者术后行调强放疗,1.8 Gy/次,5次/周,靶区放疗剂量DT50.4Gy/28次后,计划靶区缩野至大体肿瘤靶区外0.5cm,放疗推量至10Gy/5次,分次剂量2Gy/次,5次/周,总量达DT60.4Gy/33次。观察组患者行调强放疗的同时口服替莫唑胺75mg/(m2·d)。放疗结束后4周,两组同时开始口服替莫唑胺辅助化疗,单次口服剂量为150mg/(m2·d),连续5d,28d为1个周期,共6个周期。两组患者治疗过程中每周监测血常规和肝肾功能。结果 58例老年多形性脑胶质母细胞瘤术后患者放化疗结束后随访24个月,对照组患者的中位生存期为14.2个月,观察组患者的中位生存期为20.5个月,χ2=10.290,P=0.001。对照组与观察组6个月生存率分别为70.9%和91.6%(χ2=4.080,P=0.043),1年生存率分别为38.1%和72.8%,χ2=7.529,P=0.006。两组患者均出现胃肠道和血液不良反应,经对症处理后均缓解。结论替莫唑胺联合调强放疗治疗老年多形性脑胶质瘤具有协同效应,可提高治疗效果,对于老年人安全可靠,不良反应耐受性好。OBJECTIVE To compare the clinical efficacy and safety of the treatment of elderly patients with glioblastoma multiforme by temozolomide combined with intensity modulated radiotherapy with radiation alone after surgey.METHODS A retrospective study was performed on 58 patients Postoperative diagnosis of elderly glioblastoma multiforme,in Jilin Province Cancer Hospital,between May 1,2009 and May 31,2013.These patients were divided into two groups.control group（n=24）and experiment group（n=34）.Both groups were given intensity modulated radiotherapy with total dose of 60.4Gy（1.8Gy/F,5F/W,50.4Gy/28 F,after 10Gy/5F,2Gy/F,5F/W）and the experiment group underwent radiotherapy and temozolomide chemotherapy 75mg/（m2·d）.Four weeks after radiation therapy,two groups were treated with adjuvant chemotherapy,28 days for 1cycles,6cycles of chemotherapy.Weekly monitoring of blood routine,liver and kidney function of two groups of patients during treatment.RESULTS Patients were followed up for 24 months after radiotherapy and chemotherapy.The median survival time of patients in control group was14.2months,the median survival time of patients in experiment group was 20.5 months（χ2=10.290,P=0.001）.In control group and experiment group the 6months survival rates were 70.9% and 91.6%（χ2=4.080,P=0.043）.One year survival rate were 38.1% and 72.8%（χ2=7.529,P=0.006）.The adverse reaction of two groups was both tolerance.CONCLUSION Temozolomide combined with intensity-modulated radiotherapy in treatment of elderly glioblastoma multiforme have synergistic effect,improve the therapeutic effect,and is safe and reliable for the elderly.

关 键 词：老年 多形性胶质母细胞瘤 调强放疗 替莫唑胺 

分 类 号：R739.41[医药卫生—肿瘤]