胶质母细胞瘤术后替莫唑胺联合甲氨蝶呤同步会师放化疗临床观察  

Clinical observation of temozolomide and methotrexate concurrent rendezvous chemoradiotherapy after glioblastoma surgery

作　　者：高玉帅 闫兆月 禹金良 盛致远 孙勇 李治晓 马春晓 步星耀 GAO Yushuai;YAN Zhaoyue;YU Jinliang;SHENG Zhiyuan;SUN Yong;LI Zhixiao;MA Chunxiao;BU Xingyao(Department of Neurosurgery,Henan Provincial People's Hospital,Zhengzhou University People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院神经外科,郑州大学人民医院,郑州450003

出　　处：《中华实用诊断与治疗杂志》2020年第12期1278-1281,共4页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省科技攻关重点项目(192102310126)。

摘　　要：目的探讨胶质母细胞瘤术后替莫唑胺联合甲氨蝶呤同步会师放化疗的临床疗效,观察其不良反应发生情况。方法胶质母细胞瘤患者56例,随机分为对照组26例和观察组30例。2组均行肿瘤切除手术,术后对照组采用放疗同步辅助替莫唑胺化疗,观察组采用替莫唑胺联合甲氨蝶呤同步会师放化疗。记录2组患者无进展生存期、总体生存期及临床不良反应发生情况。结果观察组中位总生存期(17.8个月)、中位无进展生存期(8.4个月)及术后12、24个月患者生存率(73.3%、33.3%)均高于对照组(15.1个月、6.8个月、61.5%、23.1%)(P<0.05)。观察组血液学毒性反应、胃肠道反应、肝肾功能异常、神经系统反应及一般症状发生率(16.7%、20.0%、3.3%、10.0%、13.3%)与对照组(19.2%、19.2%、3.8%、7.7%、15.4%)比较差异均无统计学意义(P>0.05)。结论胶质母细胞瘤术后替莫唑胺联合甲氨蝶呤同步会师放化疗可延长患者生存期,不良反应较轻。Objective To investigate the clinical efficacy of postoperative radiotherapy combined with temozolomide and methotrexate rendezvous chemotherapy on glioblastoma,and to observe the adverse reactions.Methods Fifty-six patients with glioblastoma were randomly divided into observation group(n=30)and control group(n=26).Both groups underwent tumor resection,followed by radiotherapy combined with temozolomide chemotherapy in control group,and radiotherapy combined with temozolomide and methotrexate rendezvous chemotherapy in observation group.The progression-free survival,overall survival,and clinical adverse reactions were recorded in both groups.Results The median overall survival(17.8 months)and median progression-free survival(8.4 months)in observation group were longer,and postoperative 12-and 24-month survival rates(73.3%,33.3%)in observation group were higher than those in control group(15.1 months,6.8 months,61.5%,23.1%)(P<0.05).There were no significant differences in the incidences of hematological toxicity,gastrointestinal reaction,abnormal hepatic and renal function,neural reaction and general adverse reaction between observation group(16.7%,20.0%,3.3%,10.0%,13.3%)and control group(19.2%,19.2%,3.8%,7.7%,15.4%)(P>0.05).Conclusion Temozolomide and methotrexate concurrent rendezvous chemoradiotherapy after glioblastoma surgery can effectively prolong the survival of patients,and the adverse reactions are mild.

关 键 词：胶质母细胞瘤 甲氨蝶呤 替莫唑胺 会师化疗 间质化疗 

分 类 号：R739.41[医药卫生—肿瘤]