替莫唑胺联合伽玛刀立体定向放射治疗高级别脑胶质瘤预后及术后残留复发影响因素分析  

Prognosis of Temozolomide Combined with Gamma Knife Stereotactic Radiotherapy in the Treatment of High-Grade Gliomas and Influencing Factors of Postoperative Residual Recurrence

作　　者：付琳[1] 兰艳[1] FU Lin;LAN Yan(Huangshi Central Hospital·Affiliated Hospital of Hubei Polytechnic University,Huangshi,Hubei,China 435000)

机构地区：[1]黄石市中心医院·湖北理工学院附属医院,湖北黄石435000

出　　处：《中国药业》2024年第20期112-115,共4页China Pharmaceuticals

基　　金：湖北省自然科学基金创新发展联合基金项目[2022CFD062]。

摘　　要：目的探讨替莫唑胺联合伽玛刀立体定向放射治疗高级别脑胶质瘤术后残留的预后,并分析其影响因素。方法选取医院2021年1月至2023年1月收治的高级别脑胶质瘤术后残留患者117例,根据治疗方案的不同分为对照组(54例)和观察组(63例)。两组均行伽玛刀立体定向放射治疗,然后行脱水治疗3~5 d;观察组患者加服替莫唑胺胶囊,治疗2周期。比较两组临床疗效、不良反应发生情况及术后残留复发情况。采用单因素分析和二元Logistic回归分析识别联合治疗患者术后残留复发的独立危险因素。结果观察组总有效率为73.02%,显著高于对照组的48.15%(P<0.05);观察组不良反应发生率与对照组相当(55.56%比64.81%,P>0.05);观察组术后残留复发率为22.22%,显著低于对照组的40.74%(P<0.05)。患者年龄(≥60岁)、肿瘤直径(≥5 cm)及次全切治疗均为影响术后残留复发的独立危险因素(P<0.05)。结论替莫唑胺联合伽玛刀立体定向放射治疗高级别脑胶质瘤,可进一步提升疗效,降低术后残留复发风险。患者年龄(≥60岁)、肿瘤直径(≥5 cm)、次全切治疗为患者术后残留复发的独立危险因素。Objective To investigate the prognosis of temozolomide combined with Gamma Knife stereotactic radiotherapy in the treatment of postoperative residues of high-grade gliomas,and to analyze its influencing factors.Methods A total of 117 patients with postoperative residues of high-grade gliomas admitted to the hospital from January 2021 to January 2023 were selected and divided into the control group(54 cases)and the observation group(63 cases)according to different treatment regimens.The patients in the two groups underwent Gamma Knife stereotactic radiotherapy,and then received dehydration treatment for 3-5 d,on this basis,the patients in the observation group received Temozolomide Capsules orally for two cycles.The clinical efficacy,incidence of adverse reactions and postoperative residual recurrence between the two groups were compared.The univariate analysis and binary Logistic regression analysis were used to identify the independent risk factors for postoperative residual recurrence in patients receiving combined therapy.Results The total effective rate in the observation group was 73.02%,which was significantly higher than 48.15%in the control group(P<0.05).The incidence of adverse reactions in the observation group was similar to that in the control group(55.56%vs.64.81%,P>0.05).The postoperative residual recurrence rate in the observation group was 22.22%,which was significantly lower than 40.74%in the control group(P<0.05).Patients′age(≥60 years),tumor diameter(≥5 cm)and incomplete resection therapy were the independent risk factors for postoperative residual recurrence(P<0.05).Conclusion Temozolomide combined with Gamma Knife stereotactic radiotherapy in the treatment of high-grade gliomas can further improve the efficacy and decrease the risk of postoperative residual recurrence.Patients′age(≥60 years),tumor diameter(≥5 cm)and incomplete resection therapy are the independent risk factors for postoperative residual recurrence in patients.

关 键 词：替莫唑胺 伽玛刀立体定向放射 高级别脑胶质瘤 术后残留复发 影响因素 

分 类 号：R969.4[医药卫生—药理学]