立体定向放射治疗联合替莫唑胺治疗复发性脑胶质瘤的疗效  

Clinical efficacy of stereotactic radiation therapy combined with temozolomide on recurrent brain glioma

作　　者：赵惠萍[1] 刘莎 江承川[1] 李湘军 唐三元 ZHAO Huiping;LIU Sha;JIANG Chengchuan;LI Xiangjun;TANG Sanyuan(Department of Oncology, Brain Hospital of Hunan Province, Changsha 410007, China)

机构地区：[1]湖南省脑科医院肿瘤科,长沙410007

出　　处：《中南大学学报（医学版）》2018年第4期394-397,共4页Journal of Central South University ：Medical Science

基　　金：湖南省自然科学基金(2018JJ6120)~~

摘　　要：目的:探讨立体定向放射治疗联合替莫唑胺治疗复发性脑胶质瘤的临床疗效。方法:回顾性总结36例复发性脑胶质瘤患者的临床资料,其中24例患者予以立体定向放射治疗联合替莫唑胺治疗(SRT-TMZ组),12例患者予以立体定向放射治疗(SRT组),比较2组的临床疗效及不良反应。结果:复发性脑胶质瘤治疗后总有效率为66.67%,总局控率为93.94%,无晚期不良反应。其中SRT-TMZ组的总有效率为77.27%,局控率为95.45%;优于SRT组,但差异无统计学意义(P>0.05)。33例患者0.5,1,2,3年生存率分别为90.91%,63.64%,42.42%,15.15%,其中SRT-TMZ组0.5,1,2,3年生存率分别为95.45%,72.72%,54.54%,22.73%;SRT组0.5,1,2,3年生存率分别为81.82%,45.45%,18.18%,0%。生存分析显示SRT-TMZ组生存时间长于SRT组(30.00个月vs 14.00个月,P=0.010)。结论:立体定向放射治疗联合替莫唑胺是姑息性治疗复发性脑胶质瘤的有效手段,对于提高患者近期疗效和生存率有积极作用。Objective： To investigate the clinical efficacy of stereotactic radiation therapy combined with temozolomide on recurrent glioma.Methods： A total of 36 patients with recurrent glioma were retrospectively analyzed and divided into a control group（n=12）, who received stereotactic radiation therapy, and an experimental group（n=24）, who received stereotactic radiation therapy plus temozolomide. The clinical efficacy and adverse reactions for the 2 groups were compared.Results： Total effective rate and local control rate for clinical treatment were 66.67% and 93.94%, respectively. Late adverse reaction was not observed. The eff ective rate and local control rate in the experimental group were 77.27% and 95.45%, which were slight higher than those in the controlgroup, with no statistical significance（P〉0.05）. The 0.5-, 1-, 2-, 3-year follow-up total survival rates were 90.91%, 63.64%, 42.42%, and 15.15%, respectively. The 0.5-, 1-, 2-, 3-year follow-up survival rates in the experimental group were 95.45%, 72.72%, 54.54% and 22.73%, respectively, while those in the control group were 81.82%, 45.45%, 18.18%, and 0%, respectively. Survival analysis showed the survival time for the experimental group was significantly longer than that of the control group（30.00 months vs 14.00 months, P=0.010）. Conclusion： Stereotactic radiation therapy combined with temozolomide for recurrent glioma is effective, and it has positive effect on improving the clinical efficacy and survival rate for the patients.

关 键 词：脑胶质瘤 复发 立体定向放射治疗 替莫唑胺 临床疗效 

分 类 号：R739.4[医药卫生—肿瘤]