胶质瘤术后替莫唑胺化疗与射波刀放疗的效果比较  

Effect of comparison on postoperative temozolomide chemotherapy and radioknife radiotherapy for gliomas

作　　者：赵鸽 陈志功 杨彦松 李太平 李家骏 ZHAO Ge;CHEN Zhingong;YANG Yansong;LI Taiping;LI Jiajun(Departement of Neurosurgery,Zhengzhou Yihe Hospital,Zhengzhou 450047,China;Departement of Medical Yangtze University,Jingzhou 434023,China)

机构地区：[1]郑州颐和医院神经外科,郑州450047 [2]长江大学医学部,荆州434023

出　　处：《华夏医学》2024年第1期177-182,共6页Acta Medicinae Sinica

基　　金：河南省医学科技攻关项目(202000121)。

摘　　要：目的观察胶质瘤术后替莫唑胺(TMZ)化疗与射波刀放疗的近期、远期效果。方法选取87例脑胶质瘤患者,采用抽签法分为化疗组(43例)和放疗组(44例)。化疗组采用TMZ化疗,放疗组采用射波刀放疗,比较两组的各种标志物水平变化及病灶改善情况,以及随访期间的生存质量、生存周期及不良事件发生情况。结果治疗后,两组的糖类抗原153(CA153)、神经元特异性烯醇化酶(NSE)、天冬酰胺内肽酶(AEP)、肿瘤细胞增殖(Ki-67)等指数以及病灶客观缓解率(ORR)、疾病控制率(DCR)相近,差异均无统计学意义(P>0.05)。但随访期间放疗组的卡氏功能状态(KPS)评分、生活质量(QOL)评分高于化疗组;放疗组体能状况(ZPS)评分及不良事件发生率低于化疗组,差异均有统计学意义(P<0.05)。结论应用TMZ化疗或射波刀放疗对控制胶质瘤患者术后病情进展均有积极意义,但射波刀放疗在提升患者生存质量、延长生存周期、降低不良事件发生风险方面更具临床优势。Objective To observe the short-term and long-term effects of Temozolomide(TMZ)chemotherapy and radioknife radiotherapy in patients with glioma after surgery.Methods 87 patients with glioblastoma were selected and divided into the chemotherapy group(43 cases)and radiotherapy group(44 cases)by drawing lots.The chemotherapy group were received TMZ chemotherapy,while the radiotherapy group were received radioknife radiotherapy.The changes in various biomarker levels and lesion improvement after treatment were compared between the two groups,as well as the quality of life and incidence of adverse events during the follow-up period.Results After treatment,there was no statistically significant difference in the levels of carbohydrate antigen 153(CA153),neuron specific enolase(NSE),asparagine endopeptidase(AEP),tumor proliferation marker(Ki-67),objective response rate(ORR),and disease control rate(DCR)between the two groups of patients(P>0.05).During the follow-up period,the Karnofsky performance status(KPS)and quality of life score(QOL)of tumor patients in the radiotherapy group were higher than those in the chemotherapy group,while the zubrod performance status(ZPS)was lower than that in the chemotherapy group.The incidence of adverse events was lower than that in the chemotherapy group,and the differences were statistically significant(P<0.05).Conclusion The application of TMZ chemotherapy or radioknife radiotherapy has positive significance in controlling the postoperative progression of glioma patients,but radioknife radiotherapy has clinical advantages in improving patient quality of life and reducing the risk of adverse events.

关 键 词：胶质瘤 开颅切除术 替莫唑胺化疗 射波刀放疗 

分 类 号：R739.4[医药卫生—肿瘤]