【摘要】 目的回顾性分析比较Ⅲ、Ⅳ级脑胶质瘤术后单纯调强放疗和调强放疗联合替莫唑胺治疗的疗效。方法脑恶性胶质瘤术后患者68例分为两组:单纯放疗组(38例)采用调强适形放射治疗(IMRT),分割剂量为GTV-P每次2.0~2.2 Gy,每周5次,DT60~66 Gy/30 f,CTV-P每次1.8 Gy,每周5次,DT56 Gy/30 f;放化疗联合组(30例),IMRT同单纯放疗组,同时配合替莫唑胺(TMZ)口服化疗,TMZ 75 mg.m-2.d-1与放疗同步,放疗结束后间隔4周再接受4~6周期TMZ辅助化疗,辅助化疗首次剂量为150 mg.m-2.d-1,连服5 d,28 d为1疗程,根据监测血常规调整其剂量。结果单纯放疗组与放化疗联合组比较,总有效率(CR+PR)分别为39.5%和73.3%,两组差别有统计学意义(P<0.01);单纯放疗组与放化疗联合组比较,1、2、3年生存率分别为57.9%、76.7%、25.3%和49.5%、15.2%、25.9%,两组生存率比较均有统计学意义(P=0.039)。结论调强放疗联合TMZ治疗Ⅲ、Ⅳ级脑恶性胶质瘤术后患者的疗效优于单纯调强放疗。更多还原

【Abstract】 Objective To compare the treatment results in postoperative patients with Grade or glioma receiving intensity-modulated radiotherapy alone(IMRT) and IMRT plus concomitant and adjuvant temozolomide(IMRT-TMZ).Methods Sixty-eight postoperative patients with malignant glioma were randomly divided into two groups: IMRT group(38 patients) and IMRT-TMZ group(30 patients).IMRT was delivered as GTV-P DT60~66 Gy/30 f/6 weeks and CTV-P DT54 Gy/30 f/6 weeks.Remedy of TMZ was 75 mg·m-2·d-1 concomitant with IMRT,and 4 weeks after IMRT,followed by six cycles of adjuvant TMZ 150 mg·m-2·d-1 for 5 days each 28-day cycle.Results The overall response rate(complete response and partial response) was 39.5% and 73.3% respectively in IMRT group and IMRT-TMZ group,with a significant difference(P<0.01).In IMRT group and IMRT-TMZ group,the 1,2 and 3-year survival rates were 57.9% and 76.7%,25.3% and 49.5%,15.2% and 25.9%,respectively,with a significant difference(P=0.039).Conclusion The treatment results of IMRT-TMZ are better than those of IMRT and the side-effect does not markedly increase.更多还原