| 傅浩 杨灵 万林林.放疗联合替莫唑胺治疗恶性脑胶质瘤术后患者的临床研究[J].实用中西医结合临床,2010,(4):8-10 |
| 放疗联合替莫唑胺治疗恶性脑胶质瘤术后患者的临床研究 |
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| DOI： |
| 中文关键词: 恶性脑胶质瘤 三维适形放疗 替莫唑胺化疗 |
| 英文关键词: Malignant glioma,3D-conformal radiotherapy Temozolomid chemotherapy |
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| 中文摘要: |
| 目的：探讨三维适形放疗联合替莫唑胺（temozolomide,TMZ）治疗恶性脑胶质瘤术后患者的疗效和安全性。方法：选择经病理证实的恶性脑胶质瘤术后患者共28例，随机分为两组（治疗组和对照组），各14例。治疗组在适形放疗的同时采用TMZ化疗，28d为1个疗程，每例患者进行4~6个疗程的治疗；对照组仅行单纯适形放疗，两组患者放疗方法及剂量相同。所有患者治疗结束后均定期随访，进行实体肿瘤客观疗效（CR+PR）、中位复发时间、生存率、生活质量和药物安全性的评定。结果：全脑增强CT或MRI示实体肿瘤治疗有效率治疗组为50.0%，高于对照组28.6%，但两组比较差异无统计学意义（P >0.05）；治疗组1、2、3年生存率分别为85.7%（12/14）、78.6%（11/14）、57.1%（8/14），对照组分别为71.4%（10/14）、35.7%（5/14）、14.3%（2/14）；治疗组中位复发时间为21个月，对照组中位复发时间为17个月，2、3年生存率及中位复发时间两组比较，差异均有统计学意义(P <0.05)。治疗组常见不良反应有恶心、呕吐、头痛及骨髓抑制等，发生率低，且仅限于I、II级，经对症治疗后未影响治疗的进行，治疗组患者生活质量的改善情况明显优于对照组。结论：放疗联合口服TMZ治疗恶性脑胶质瘤术后患者疗效优于局部单纯放疗，能延缓中位复发时间，提高2、3年生存率；不良反应轻微，明显改善患者生活质量。 |
| 英文摘要: |
| Objective:To evaluate the efficacy and safety of temozolomide(TMZ) plus concomitant 3-Dimension conformal radiotherapy(3D-CRT) in patients with postoperative malignant intracranial glioma.Methods:28 postoperative patients with malignant gliona were randomly divided into two groups(control group and treatment group),each group include 14 cases.The treatment group patients receive four or six cycles of temozolomide concomitantly with 3D-CRT; The control group cases only receive radiotherapy alone. After treatment, all patients followed up periodically.Results: Whole-brain CT or MRI showed that the overall response rates(CR+PR) were 50.0% in treatment group and 28.6% in the control group,There was no significance difference between the two groups(P >0.05); Median recurrent time was 21 months in the treatment group and 17 months in the control group(P <0.05); The 1、2、3-year survival rates were 85.7%（12/14）、78.6%（11/14）and 57.1% in the treatment group and 71.4%（10/14）、35.7%（5/14）and 14.3%（2/14） in the control group.A significant difference was found in 2、3 year survival rate between the two group(P <0.05).The main side effects in treatment group including nausea,vomiting, myelosuppression,and headache(gradeⅠ~Ⅱ), the incidence was low.Conclusion:Three dimensional conformal radiotherapy combined with temozolomide could be more effective than radiotherapy alone in postoperative malignant glioma,and no more adverse effect, clear improve the quality of life. |
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