替莫唑胺联合立体定向放射治疗复发性脑胶质瘤的临床疗效  

Clinical efficacy of temozolomide combined with X-ray stereotactic radiotherapy in the treatment of recurrent glioma

作　　者：钟琪 李宗平 吴健 张烨 Zhong Qi;Li Zongping;Wu Jian;Zhang Ye(Mianyang Central Hospital,School of medicine,University of Electronic Science and Technology,Mianyang 621000,China)

机构地区：[1]电子科技大学医学院附属绵阳医院,绵阳市中心医院,绵阳621000

出　　处：《中国医师杂志》2022年第5期745-748,共4页Journal of Chinese Physician

摘　　要：目的观察替莫唑胺联合立体定向放射治疗复发性脑胶质瘤患者的临床疗效。方法回顾性选取2018年1月至2019年1月绵阳市中心医院收治的48例复发性脑胶质瘤患者,其中采用立体定向放射治疗的24例患者为对照组,采用替莫唑胺联合立体定向放射治疗的24例患者为观察组。比较两组患者治疗效果、炎症因子水平、不良反应发生率及生存率。结果观察组治疗完全缓解率及总有效率明显高于对照组(66.7%vs 37.5%,87.5%vs 62.5%),差异有统计学意义(均P<0.05)。两组治疗前血清肝细胞生长因子(HGF)、肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)水平比较差异无统计学意义(均P>0.05);治疗后两组血清HGF、TNF-α和IL-17水平均明显低于治疗前(均P<0.05),且观察组血清HGF、TNF-α和IL-17水平均低于对照组,差异有统计学意义(均P<0.05)。观察组治疗期间的不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。随访6、12、18个月,观察组患者生存率明显高于对照组,差异均有统计学意义(均P<0.05)。结论替莫唑胺联合立体定向放射治疗复发性脑胶质瘤的临床疗效优于单纯立体定向放射治疗,有效提升患者生存率,建议临床推广。Objective To investigate the curative efficacy of X-ray stereotactic radiotherapy combined with temozolomide in the treatment of recurrent glioma.Methods 48 patients with recurrent glioma treated in Mianyang Central Hospital from January 2018 to January 2019 were retrospectively selected,including 24 patients treated with stereotactic radiotherapy as the control group and 24 patients treated with temozolomide combined with stereotactic radiotherapy as the observation group.The treatment effect,inflammatory factor level,incidence of adverse events and survival rate were compared between the two groups.Results The complete remission rate and total effective rate in the observation group were significantly higher than those in the control group(66.7%vs 37.5%,87.5%vs 62.5%)(all P<0.05).There were no significant differences in serum levels of hepatocyte growth factor(HGF),tumor necrosis factor-α(TNF-α)and interleukin-17(IL-17)between the two groups before treatment(all P>0.05).After treatment,the serum levels of HGF,TNF-α and IL-17 in observation group was significantly lower than those in control group(all P<0.05).The incidence of adverse events in the observation group was significantly lower than that in the control group(P<0.05).During follow-up of 6,12 and 18 months,the survival rate of patients in the observation group was significantly higher than that in the control group,with statistically significant difference(all P<0.05).Conclusions The combination of X-ray stereotactic radiotherapy with temozolomide in the treatment of recurrent glioma shows better clinical outcome and extended survival rate.To conclude,this combined treatment is recommended in further clinical promotion.

关 键 词：神经胶质瘤 肿瘤复发 替莫唑胺 放射疗法 

分 类 号：R739.41[医药卫生—肿瘤]