替莫唑胺治疗神经胶质瘤患者疗效与安全性的回顾性分析  

The curative effect and safe analysis of temozolomide for neuroglioma patients

作　　者：丁吉涛[1] 李明浩[1] 李琳坤 王东海 Ding Jitao;Li Minghao;Li Linkun;Wang Donghai(Department of Neurosurgery,Nanyang Second People's Hospital,Henan Nanyang 473132,China.)

机构地区：[1]南阳市第二人民医院神经外科

出　　处：《现代肿瘤医学》2019年第23期4187-4190,共4页Journal of Modern Oncology

基　　金：南阳市第二人民医院科研项目(编号:2019010)

摘　　要：目的:研究替莫唑胺(temozolomide,TMZ)治疗神经胶质瘤患者的疗效,探讨其安全性和应对措施。方法:回顾性分析2009年6月至2015年6月在我院神经外科就诊并接受TMZ治疗的神经胶质瘤患者的临床资料,复诊和随访资料齐全者95例,其中32例低分级胶质瘤接受单纯TMZ化疗,23例高分级胶质瘤接受单纯TMZ化疗,40例高分级胶质瘤接受TMZ同步放化疗。比较患者1年、2年、3年生存率,统计患者出现的不良反应,比较不同性别、肿瘤级别和是否接受放疗患者间不良反应发生率。结果:低级别组生存率显著高于高级别组(P<0.05),而高级别组中不同治疗方法间生存率无显著差异(P>0.05)。共发生骨髓毒性类不良反应22(23.16%)例,胃肠道反应21(22.11%)例,皮肤不良反应58(61.05%)例;女性患者发生率均显著高于男性患者(P<0.05);接受放疗的患者骨髓毒性和皮肤不良反应发生率显著高于单纯化疗的患者(P<0.05),但两者胃肠道反应发生率差异无统计学意义(P>0.05)。结论:替莫唑胺对神经胶质瘤具有良好的疗效及安全性,但对女性和同时接受放疗的患者应加强预防性治疗,减少不良反应的发生。Objective:To investigate the curative effect of temozolomide for neuroglioma,analyze the safety and strategy to adverse reaction.Methods:Retrospectively analyze clinical data of neuroglioma patients diagnosed in our hospital from June 2009 to June 2015.95 cases were selected with complete return visit and follow-up survey.In which 32 low-grade and 23 high-grade gliomas patients received TMZ only,40 high-grade gliomas patients received concurrent chemoradiotherapy.The 1-year,2-year,3-year survival rate were compared.And we counted all the adverse reaction,and the reaction rates in different gender,tumor classification and radiotherapy were compared.Results:The survival rates of low-grade gliomas patients was significantly higher than that of high-grade gliomas(P<0.05).There was no difference between different therapy in high-grade gliomas patients(P>0.05).All we counted adverse reaction were 22(23.16%) cases of bone marrow, 21(22.11%) of gastrointestinal reaction and 58(61.05%)of skin or mucosa.The adverse reaction incidence rate of females was significantly higher than that of males(P<0.05).The hematologic toxicity and skin adverse reaction of patients received concurrent chemoradiotherapy was significantly higher than that of patients received only temozolomide(P<0.05),but there was no difference between gastrointestinal reaction rates of two group(P>0.05).Conclusion:Temozolomide has a good curative effect and security for neuroglioma,but more prophylactic treatment may be applied to female patients and patients received concurrent chemoradiotherapy to reduce the adverse reaction.

关 键 词：替莫唑胺 神经胶质瘤 不良反应 疗效 

分 类 号：R739.41[医药卫生—肿瘤]