复发高级别胶质瘤应用IMRT再程放疗的临床评价  

Clinical evaluation of re-radiotherapy by using intensity modulated radiation therapy for recurrent high-grade glioma

作　　者：丁建明 汪庚明[1] 江浩[1] DING Jianming;WANG Gengming;JIANG Hao(Department of Radiotherapy,First Affiliated Hospital of Bengbu Medical University,Bengbu,Anhui 233000,China)

机构地区：[1]蚌埠医学院第一附属医院放疗科,安徽蚌埠233000

出　　处：《检验医学与临床》2021年第22期3244-3246,共3页Laboratory Medicine and Clinic

基　　金：安徽省卫生厅“十二五”临床重点专科建设项目(01Z33)。

摘　　要：目的探讨复发高级别胶质瘤应用调强放疗(IMRT)再程放疗的疗效及安全性,分析影响预后的因素。方法筛选28例复发高级别胶质瘤患者的临床资料进行回顾性分析,所有患者均行IMRT再程放疗,20例患者联合替莫唑胺(TMZ)进行化疗,评价IMRT的疗效及安全性,分析影响预后的因素。结果近期疗效:完全缓解(CR)3例(10.7%)、部分缓解(PR)10例(35.7%)、稳定(SD)9例(32.1%)、进展(PD)6例(21.5%),有效率为46.4%、稳定率为78.6%;3年的累计生存率达37.04%,中位无进展生存时间17.8个月,6个月和12个月的中位无进展生存率分别为62.96%和51.85%,平均生存时间为21.6个月;不良反应多为轻度、可逆;复发时年龄、病理分级、卡氏功能状态量表(KPS)评分、复发距首次治疗结束时间与预后有关(P<0.05)。结论IMRT治疗复发高级别胶质瘤患者有效且安全性佳;复发时年龄、KPS评分、病理分级等因素影响患者的预后。Objective To investigate the efficacy and safety of re-radiotherapy by using intensity modulated radiation therapy(IMRT)for recurrent high-grade glioma,and to analyze the factors affecting the survival and prognosis.Methods The clinical data in screened 28 cases of recurrent high-grade glioma were retrospectively analyzed,all cases underwent IMRT re-radiotherapy,among them 20 cases received the temozolomide(TMZ)combined chemotherapy.The efficacy and safety were evaluated.The factors affecting prognosis were analyzed.Results The short-term efficacy:complete response(CR)in 3 cases(10.7%),partial response(PR)in 10 cases(35.7%),stable disease(SD)in 9 cases(32.1%),progressive disease(PD)in 6 cases(21.5%),the effective rate(CR+PR)was 46.4%,the stability rate(CR+PR+SD)was 78.6%;the 3-year cumulative survival rate was 37.04%,the median progression-free survival(PFS)time was 17.8 months,6-month and 12-month PFS rate were 62.96%and 51.85%,respectively,the average survival time was 21.6 months;the adverse reactions were mild and reversible;the age at recurrence,pathological grade,KPS score,time from recurrence to the initial treatment end were related with prognosis.Conclusion IMRT is effective in treating recurrent high-grade glioma with good safety;the factors such as age at recurrence,KPS score,pathological grade etc.affect the prognosis of the patients.

关 键 词：复发胶质瘤 再程放疗 调强放疗 

分 类 号：R739.41[医药卫生—肿瘤]