高级别胶质瘤术后同步放化疗+替莫唑胺长周期辅助化疗的研究  

A study of Postoperative Temozolomide Concurrent Chemoradiotherapy and Temozolomide Long-term Adjuvant Chemotherapy for a Newly Diagnosed High-grade Glioma

作　　者：龚巧英 熊文敏[1] 吴新生 彭世义 李国庆 GONG Qiaoying;XIONG Wenmin;WU Xinsheng(Jiangxi Cancer Hospital,Nanchang,330029)

机构地区：[1]南昌大学附属肿瘤医院,江西省肿瘤医院,330029

出　　处：《实用癌症杂志》2021年第7期1202-1204,1210,共4页The Practical Journal of Cancer

基　　金：江西省卫生计生委科技计划(编号:20175413);江西省卫生计生委项目(编号:20161106)。

摘　　要：目的探讨高级别胶质瘤术后同步放化疗后替莫唑胺长疗程辅助化疗对PFS及OS的影响。方法45例术后病理诊断为高级别胶质瘤患者;术后给予瘤床D T60-64Gy/30次放疗,同步替莫唑胺化疗75 mg/m^(2)×42天,放疗完成后4周给予替莫唑胺150~200 mg/m^(2) qd×5 q4w,持续服用至患者拒绝或肿瘤进展。结果辅助周期数>6个周期的PFS较辅助周期数≤6个周期的有显著性差异(P=0.001)。辅助周期数>6个周期的OS较辅助周期数≤6个周期的有显著性差异(P=0.004)。45例患者中有6例出现Ⅲ度以上骨髓抑制,9例出现Ⅱ度骨髓抑制,2例出现感染,3例患者非肿瘤相关性原因死亡。结论长疗程TMZ辅助性化疗可以提高高级别胶质瘤的PFS和OS,毒副作用可以耐受。Objective To investigate the effects of temozolomide long course adjuvant chemotherapy on PFS and OS after concurrent chemoradiotherapy for high-grade glioma.Methods 45 patients with high grade glioma were pathologically diagnosed after operation.Tumor bed D T60Gy/30Fx radiotherapy was given after surgery,along with temozolomide chemotherapy at 75mg/m^(2)×42 days.Temozolomide was given at 150-200mg/m^(2) qd×5 every 4 weeks after the completion of radiotherapy,and continued until the patient refused or the tumor progressed.Results PFS with the number of auxiliary cycles>6 cycles was significantly different from PFS with the number of auxiliary cycles≤6 cycles(P=0.001).The OS of the group with>6 auxiliary cycles was significantly different from that of the group with≤6 auxiliary cycles(P=0.004).Of the 45 patients,6 had grade III or higher myelosuppression,9 had grade II myelosuppression,2 had infection,and 3 died from non-tumor-related causes.Conclusion Long course of TMZ adjuvant chemotherapy can improve the PFS and OS of high-grade glioma,and the toxic and side effects can be tolerated.

关 键 词：高级别胶质瘤 替莫唑胺 长疗程 中枢神经系统肿瘤 

分 类 号：R739.41[医药卫生—肿瘤]