【摘要】 目的分析术后长周期(≥9周期)替莫唑胺(TMZ)治疗高级别胶质瘤的效果、不良反应及对预后的影响。方法收集高级别胶质瘤患者100例,根据术后使用TMZ的周期数不同,分为标准周期(6周期)与长周期(≥9周期)治疗组。分析比较两组患者的无进展生存期(PFS)和总生存期(OS),以及对预后的影响因素。结果标准周期组患者的中位PFS和OS分别是17(6～51)个月和25(6～55)个月,长周期组的中位PFS和OS分别是29(10～55)个月和38(9～65)个月,两组PFS、OS比较差异均有统计学意义(均P <0.05)。年龄、肿瘤切除程度、IDH突变状态及TMZ使用周期数对预后的影响有统计学意义。标准周期组患者最常见的不良反应是疲乏、血小板减少、中性粒细胞减少;长周期组患者最常见的不良反应是疲乏、中性粒细胞减少及血小板减少;延长TMZ服药周期没有明显增加不良反应。结论术后长周期TMZ治疗高级别胶质瘤可一定程度延长患者的PFS和OS;并且未出现明显不可耐受的不良反应。更多还原

【Abstract】 Objective To analyze the effect,adverse reactions and prognosis of long term(≥ 9 cycles) temozolomide(TMZ) treatment for high-grade glioma after operation.Method 100 patients with high-grade glioma were divided into standard cycle(6 cycles) group and long cycle(≥9 cycles) group according to the number of cycles of TMZ.The progression free survival(PFS),overall survival(OS) and prognostic factors of the two groups were analyzed and compared.Results The median PFS and OS of the standard cycle group were 17(6-51) months and 25(6-55)months respectively,and the median PFS and OS of the long cycle group were 29(10-55) months and 38(9-65) months respectively.There were significant differences in PFS and OS between the two groups(all P < 0.05).Age,tumor resection degree,IDH mutation status and the number of TMZ cycles had significant effects on the prognosis.The most common adverse reactions in the standard cycle group were fatigue,thrombocytopenia and neutropenia; the most common adverse reactions in the long cycle group were fatigue,neutropenia and thrombocytopenia; prolonging the TMZ medication cycle did not significantly increase the adverse reactions.Conclusion The PFS and OS of patients with high-grade gliomas can be prolonged to a certain extent after long-term TMZ treatment,and there is no obvious intolerable adverse reactions.更多还原