高级别脑胶质瘤术后同步加量与序贯加量调强放疗疗效比较  

Comparison of clinical efficacy between postoperative simultaneous and sequential integrated boost intensity-modulated radiotherapy for high-grade glioma

作　　者：李锋[1] 王国辉 常晓静[1] 李昊楠 刘会芝[1] 盖晓惠[1] Li Feng;Wang Guohui;Chang Xiaojing;Li Haonan;Liu Huizhi;Ge Xiaohui(Department of Radiation Oncology,The second hospital of Hebei medical university,Shi Jiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院放疗科,石家庄050000

出　　处：《中华放射肿瘤学杂志》2022年第6期513-518,共6页Chinese Journal of Radiation Oncology

摘　　要：目的探讨高级别脑胶质瘤术后同步加量调强放疗和术后序贯加量调强放疗的疗效及不良反应。方法回顾性分析2010年1月至2017年12月连续住院行术后放疗的高级别脑胶质瘤患者142例,根据治疗方式分为同步加量调强放疗及序贯加量调强放疗两组,两组放疗期间均给予替莫唑胺同步化疗,对比两组患者的随访情况。结果全组的中位总生存(OS)为24个月,中位无进展生存(PFS)为17个月,中位无瘤生存(DFS)为25个月;同步加量放疗组与序贯加量放疗组的中位OS分别为27.2个月和21个月(P=0.950),中位PFS分别为21.2个月与15个月(P=0.21),中位DFS分别为28个月与18个月(P=0.171),疾病控制率分别为92.86%与85.17%(P=0.541),两组OS、PFS、DFS、近期疗效及不良反应方面差异均无统计学意义,但同步加量组的适形性优于序贯加量组(P=0.032)。结论高级别脑胶质瘤术后同步加量对比序贯加量调强放疗,在生存期、近期疗效及治疗不良反应方面差异均无统计学意义,但同步加量组适形性明显更好,可推荐用于高级别脑胶质瘤术后放疗。Objective To compare the efficacy and side effects between simultaneous and sequential integrated boost intensity-modulated radiotherapy after operation for high-grade glioma.Methods We retrospectively analyzed 142 patients with high-grade glioma who underwent postoperative radiotherapy from January 2010 to December 2017.All patients were divided into the simultaneous and sequential integrated boost intensity-modulated radiotherapy groups.Concurrent temozolomide chemotherapy was delivered during radiotherapy in two groups.The follow-up outcomes were statistically compared between two groups.Results For the whole group,the median overall survival(OS)was 24 months,the median progression-free survival(PFS)was 17 months,and the median disease-free survival(DFS)was 25 months.In the simultaneous and sequential integrated boost intensity-modulated radiotherapy groups,the median OS were 27.2 and 21.0 months(P=0.950),the median PFS were 21.2 and 15.0 months(P=0.21),and the median DFS were 28.0 and 18.0 months(P=0.171),and the disease control rates were 92.86%and 85.17%(P=0.541),respectively.There was no statistical difference in OS,PFS,DFS,short-term efficacy and side effects between two groups.However,the conformity index in the simultaneous integrated boost intensity-modulated radiotherapy group was better than that in the sequential integrated boost intensity-modulated radiotherapy group(P=0.032).Conclusions Postoperative simultaneous and sequential integrated boost intensity-modulated radiotherapy yield no statistical differences in the survival,short-term efficacy and side effects in the treatment of high-grade glioma.However,the conformity index in the simultaneous integrated boost intensity-modulated radiotherapy group is significantly better,which can be recommended for postoperative radiotherapy of high-grade glioma.

关 键 词：高级别脑胶质瘤/放射疗法 同步加量调强放疗 序贯加量调强放疗 预后 

分 类 号：R739.41[医药卫生—肿瘤] R730.55[医药卫生—临床医学]