调强放疗与三维适型放疗联合替莫唑胺治疗恶性脑胶质瘤患者的临床疗效观察  

Comparison of intensity modulated radiotherapy and three-dimensional conformal radiotherapy combined with concurrent chemotherapy of temozolomide for malignant glioma patients

作　　者：林展[1] 梁雷锋[1] 甘媚[1] 李国余 严浩林[1] Lin Zhan;Liang Leifeng;Gan Mei;Li Guoyu;Yan Haolin(Department of Oncology,Yulin First People's Hospital,Guangxi Yulin 537000,China.)

机构地区：[1]玉林市第一人民医院肿瘤科

出　　处：《现代肿瘤医学》2019年第23期4179-4182,共4页Journal of Modern Oncology

摘　　要：目的:比较调强放疗与三维适型放疗联合替莫唑胺治疗恶性脑胶质瘤患者的临床疗效。方法:选取2011年3月至2016年3月本院收治的恶性脑胶质瘤患者140例为研究对象,采用随机平行对照法将其分为两组各70例。A组给予调强放疗联合替莫唑胺治疗,B组给予三维适型放疗联合替莫唑胺治疗。观察两组患者近期治疗效果、远期预后情况、肿瘤标志物、免疫因子及海马功能。结果:两组RR分别为24.29%、22.86%,DCR分别为62.86%、60.00%,差异无统计学意义(P分别为0.842、0.728>0.05)。两组TTP、PFS、OS比较差异无统计学意义(P>0.05)。治疗前,两组患者SIL-2R、PTN、IgE、TNF-α、IL-6水平比较差异无统计学意义(P>0.05);治疗后,A组SIL-2R、PTN、IgE、TNF-α、IL-6水平显著低于B组(P<0.05)。治疗前,两组NCF评分比较差异无统计学意义(P>0.05);治疗后1个月、3个月后,B组患者NCF评分显著低于治疗前,且显著低于A组(P<0.05)。结论:调强放疗与三维适型放疗联合替莫唑胺治疗恶性脑胶质瘤对疾病控制效果相当,但前者治疗安全性较高、海马功能损伤较小,具有重要临床价值。Objective:To compare the intensity modulated radiotherapy and three-dimensional conformal radiotherapy combined with concurrent chemotherapy of temozolomide for malignant glioma patients.Methods:140 cases malignant glioma patients with postoperative tumor residual who received surgical treatment from March,2011 to March,2016 were selected as the research objects,and were divided into two groups with 70 cases in each by random number table.Group A was given intensity modulated radiotherapy combined with concurrent chemotherapy of temozolomide,and group B was given three-dimensional conformal radiotherapy combined with concurrent chemotherapy of temozolomide.The recent therapeutic effect,long-term prognosis tumor biomarkers and immune indice,and hippocampal function in two groups were observed.Results:RR in two groups were 24.29% and 22.86%,and DCR were 62.86% and 60.00%.The difference was not statistically significant(P= 0.842,0.728>0.05).TTP,PFS and OS in two groups had no significant differences(P>0.05).Before treatment,there was no statistically significant difference between SIL-2 R,PTN,IgE,TNF-α and IL-6 in two groups(P>0.05).After treatment,the differences of SIL-2 R,PTN,IgE,TNF-α and IL-6 in two groups were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in NCF scores between two groups(P>0.05).After 1 month and 3 months treatment,NCF scores of patients in group B were significantly lower than those before treatment and significantly lower than those in group A(P<0.05).Conclusion:Intensity modulated radiotherapy combined with concurrent chemotherapy of temozolomide has similar effects on disease control with three-dimensional conformal radiotherapy,but the treatment has higher safety and less damage to hippocampal function,which has important clinical value.

关 键 词：恶性脑胶质瘤 调强放疗 三维适型放疗 替莫唑胺 海马保护 

分 类 号：R739.41[医药卫生—肿瘤]