恶性脑胶质瘤单放和放化疗临床疗效5年随诊分析  

Five-year follow-up analysis of clinical efficacy of radiotherapy alone and radiochemotherapy in malignant glioma

作　　者：刘伟[1] Liu Wei(Department of Neurosurgery,Tianjin Huanhu Hospital,Nankai University,Tianjin 300350,China)

机构地区：[1]南开大学附属环湖医院神经外科,天津300350

出　　处：《岭南现代临床外科》2022年第1期89-93,共5页Lingnan Modern Clinics in Surgery

摘　　要：目的分析恶性脑胶质瘤术后单纯放射治疗、同步放射治疗加化学治疗的临床疗效。方法本次研究我们回顾性分析了南开大学附属环湖医院神经外科自2015年10月至2016年9月共99例恶性脑胶质瘤患者资料,单纯放射治疗(单放)组48例,同步放射治疗加化疗(放化)组51例。两组患者均在术后20 d左右开始常规放射治疗,进行2 Gy/天,分30次,共计60 Gy的放疗,持续42天(周六、周日不放疗)。同步放射治疗加化疗(放化)组在持续42 d的放疗中同时加用化疗,方案为口服替莫唑胺胶囊75 mg/m^(2)·d,共计42天;随后同步放射治疗加化疗期结束后4周,接受共计6个周期的替莫唑胺的辅助治疗,每个周期为28天,每个周期的方案为200 mg/m^(2)·d,每日1次,共5 d,然后停药23 d,治疗可一直持续到肿瘤病变出现进展,最长治疗时间为2年。统计所有病例的1、3、5年生存率,分析恶性脑胶质瘤术后单纯放射治疗、同步放射治疗加化学治疗的临床疗效。结果 1、3、5年生存率单放组分别为54.2%、29.2%、10.4%,放化组分别为74.5%、51.0%、31.4%,放化组高于单放组(P<0.05)。放化组恶心、呕吐等急性反应明显加重,骨髓抑制和听力水平下降、记忆力减退等远期损伤两组病例无显著差异性。结论恶性脑胶质瘤术后采用同步放射治疗加化学治疗可提高疗效。Objective To analysis the clinical efficacy of radiotherapy alone and concurrent chemoradiotherapy of malignant glioma after operation.Methods The retrospective study included 99 cases of malignant glioma after operation were performed in Neurosurgery Departments of Huanhu Hospital from Oct 2015 to Sept 2016.All the 99 cases of patients weredivided into two groups:radiotherapy alone group(48 cases)and concurrent chemoradiotherapy group(51 cases).All patients began routine postoperative radiation therapy in 20 days or so,make 2 Gy/day,divided 30 times,totaling 60 Gy of radiotherapy,sustained 42 days(except Saturday and Sunday).The concurrent chemoradiotherapy group perform the program for temozolomide 75 mg/m^(2)·day for 42 days simultaneously;then after four weeks,the groupaccept 6 cycles of temozolomide adjuvant therapy,the program is 200 mg/m^(2)·day,once daily for5 days,then 23 days withdrawal,treatment may continue until disease progression,up to 2 years.The 1,3 and 5-year survival rates of all cases were counted,and the clinical effects of radiotherapy alone and concurrent chemoradiotherapy of malignant glioma after operation were analyzed.Results 1,3,5-year survival rate of the radiotherapy alone group were 54.2%,29.2%,10.4%,and the concurrent chemoradiotherapy group were 74.5,51.0%,31.4%.The concurrent chemoradiotherapy group was higher than the radiotherapy alone group(P<0.05).The concurrent chemoradiotherapy group had higher acute reaction such asnausea and vomiting,but bone marrow suppression,hearing loss,memory loss and other long-term damages were similar in the two groups.Conclusion The concurrent chemoradiotherapy after malignant glioma operation may improve the outcome.

关 键 词：恶性脑胶质瘤 放射治疗 化学治疗个性化治疗 预后 

分 类 号：R739.41[医药卫生—肿瘤]