高级别脑胶质瘤手术后联合放化疗疗效观察
Therapeutic effect of combined temozolomide and radiotherapy or chemotherapy on high-grade glioma after operation
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摘要: 目的 观察高级别脑胶质瘤术后经替莫唑胺(TMZ)联合放疗与尼莫司汀(ACNU)结合放疗后的近期疗效及安全性。方法 经手术后病理确诊的高级别脑胶质瘤病人77例,术后分为替莫唑胺联合放疗组(TMZ-RT组)39例与尼莫司汀结合放疗组(ACNU-RT组)38例,分别服用替莫唑胺(TMZ)和尼莫司汀(ACNU)4-6个疗程。同时进行放疗,总照射剂量60Gy,2Gy/次,1次/d,5次/周。结果 TMZ-RT组有效率、控制率(82.1%,92.3%)均明显高于ACNU-RT组(60.5%,73.7%),两组差异具统计学意义(P<0.05)。药物安全性评价显示,TMZ-RT组主要不良反应为乏力、恶心呕吐及一过性白细胞减少,且多限于I-Ⅱ度,相比较于ACNU-RT组,发生不良反应病例数较少,且程度也较轻。结论 与ACNU结合放疗组相比,TMZ联合放疗组对高级别胶质瘤术后患者更安全、有效。Abstract: Objective To observe the therapeutic effect and safety of combined temozolomide（TMZ） and radiotherapy（RT） or combined nimustine and RT for high-grade glioma after operation. Methods Seventy-seven patients with high-grade glioma were enrolled in this study and divided into TMZ-RT group（n=39） and nimustine-RT group（n=38）.The patients underwent 4-6 courses of TMZ-RT and nimustine-RT,respectively,with a total irradiation dose of 60Gy,2Gy once a day,5 times a week. Results The effective and control rates were significantly higher in TMZ-RT group than in nimustine-RT group（82.1% and 92.3% vs 60.5% and 73.7%,P＜0.05）.The main side effects of TMZ-RT were nausea,vomiting,anorexia and transient leucopenia.The number of side effects was less and the severity of side effects was milder in TMZ-RT group than in nimustine-RT group. Conclusion TMZ-RT is more safe and effective for high-grade glioma than nimustine-RT.
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