替莫唑胺化疗联合放疗治疗高级别脑胶质瘤的疗效及其对血清标志物的作用  

Effect of temozolomide chemotherapy combined with radiotherapy on high grade gliomas and serum markers

作　　者：黄陈铭[1] 宋施委[2] 黄瑞宏[1] 周希汉[1] 肖连福[1] HUANG Chenming;SONG Shiwei;HUANG Ruihong;ZHOU Xihan;XIAO Lianfu(Department of Neurosurgery,Sanming Second Hospital,Yongan 366000,Fujian,China;Department of Neurosurgery,Fujian Medical University Union Hospital,Fuzhou 350001,Fujian,China)

机构地区：[1]三明市第二医院(福建中医药大学第五临床医学院)神经外科,福建永安366000 [2]福建医科大学附属协和医院神经外科,福州350001

出　　处：《癌症进展》2021年第24期2518-2521,共4页Oncology Progress

摘　　要：目的探究替莫唑胺化疗联合放疗治疗高级别脑胶质瘤的疗效及其对血清标志物的作用。方法将82例高级别脑胶质瘤患者按照治疗方式的不同分为单一放疗组与联合化疗组,每组41例。单一放疗组采用常规术后放疗,联合化疗组在单一放疗组的基础上给予替莫唑胺化疗。比较两组患者治疗前后的血管内皮生长因子(VEGF)水平、表皮生长因子(EGF)水平、T淋巴细胞亚群水平、卡氏功能状态(KPS)评分和生活质量(QOL)评分、蒙特利尔认知评估量表(MoCA)评分及近期临床疗效。结果治疗后,联合化疗组患者VEGF、EGF水平均明显低于单一放疗组(P﹤0.01),CD8^(+)明显低于单一放疗组(P﹤0.01),CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均明显高于单一放疗组(P﹤0.01),KPS、QOL、MoCA评分均明显高于单一放疗组(P﹤0.01)。联合化疗组患者总有效率为90.24%,高于单一放疗组的75.61%,差异有统计学意义(P﹤0.05)。联合化疗组患者不良反应总发生率为7.32%,明显低于单一放疗组的24.39%,差异有统计学意义(P﹤0.01)。结论替莫唑胺化疗联合放疗治疗高级别脑胶质瘤,可降低对患者认知功能造成的影响,改善患者的T淋巴细胞亚群水平及血清标志物水平。Objective To investigate the effect of timozolomide combined with radiotherapy on the high-grade glio-ma and the role of serum markers.Method According to different treatment methods,a total of 82 patients were divided into single radiotherapy group and combination chemotherapy group,41 patients in each group.The single radiotherapy group received the conventional postoperative method,and the combination chemotherapy group was given temozolo-mide chemotherapy on the basis of the single radiotherapy group.The levels of vascular endothelial growth factor(VEGF),epidermal growth factor(EGF),T lymphocyte subsets,Karnofsky performance status(KPS)score,quality of life(QOL)score,Montreal cognitive assessment(MoCA)score and short-term clinical efficacy were compared between the two groups before and after treatment.Result After treatment,the levels of VEGF and EGF in the combined chemo-therapy group were significantly lower than those in the single radiotherapy group(P<0.01),the level of CD8+was signifi-cantly lower than that in the single radiotherapy group(P<0.01),the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were significantly higher than those in the single radiotherapy group(P<0.01),the scores of KPS,QOL and MoCA were significantly higher than those in the single radiotherapy group(P<0.01).The total effective rate in the combined chemotherapy group was 90.24%,higher than 75.61%in the single radiotherapy group(P<0.05).The total incidence of adverse reactions in the combined chemotherapy group was 7.32%,significantly lower than 24.39%in the single radiotherapy group(P<0.01).Conclusion The intervention of timozolomide combined with radiotherapy on patients with advanced glioma can reduce the influence of cognitive function,and improve T lymphocyte subsets and the serum markers of patients.

关 键 词：替莫唑胺 放疗 脑胶质瘤 血清标志物 

分 类 号：R739.41[医药卫生—肿瘤]