CAJ | 학술논문

背景与目的:脑胶质瘤发病率高,预后差,寻找新的治疗方法成为这种疾病研究的热点.本研究通过前瞻性随机对照研究来观察三维适形放疗(3D-CRT)联合营莫唑胺同步化疗治疗脑胶质瘤术后残留患者的临床疗效.方法:62例术后有残留的脑胶质瘤患者前瞻性分组:单纯三维适形放疗(单放组)及三维适形放疗加同步化疗(放化组),各31例.两组均接受j维适形放疗,6 MV-X射线,2.0 Gy/f,1次/天,5次/周,处方剂量50～60 Gy/5～6周.放化组加用替莫唑胺75 mg/(m~2·d),从放疗第1天开始口服到放疗结束,随后继续给予替莫唑胺150～200 mg/(m~2·d),治疗5 d,每28 d为1个周期,共3～6个周期.结果:单放组总有效率35.5%(11/31),放化组61.3%(19/31),统计学差异显著(P=0.042);两组生存比较无统计学差异(P=0.263).分层分析显示:病理Ⅲ级脑胶质瘤同步放化疗生存优于单纯放疗组(P=0.043).结论:病理Ⅲ级脑胶质瘤术后三维适形放疗联合同步化疗,可以取得较单纯三维适形放疗更好的疗效.
배경여목적:뇌효질류발병솔고,예후차,심조신적치료방법성위저충질병연구적열점.본연구통과전첨성수궤대조연구래관찰삼유괄형방료(3D-CRT)연합영막서알동보화료치료뇌효질류술후잔류환자적림상료효.방법:62례술후유잔류적뇌효질류환자전첨성분조:단순삼유괄형방료(단방조)급삼유괄형방료가동보화료(방화조),각31례.량조균접수j유괄형방료,6 MV-X사선,2.0 Gy/f,1차/천,5차/주,처방제량50～60 Gy/5～6주.방화조가용체막서알75 mg/(m~2·d),종방료제1천개시구복도방료결속,수후계속급여체막서알150～200 mg/(m~2·d),치료5 d,매28 d위1개주기,공3～6개주기.결과:단방조총유효솔35.5%(11/31),방화조61.3%(19/31),통계학차이현저(P=0.042);량조생존비교무통계학차이(P=0.263).분층분석현시:병리Ⅲ급뇌효질류동보방화료생존우우단순방료조(P=0.043).결론:병리Ⅲ급뇌효질류술후삼유괄형방료연합동보화료,가이취득교단순삼유괄형방료경호적료효.
Background and purpose: Cerebral gliomas is one of the common brain tumors, and has a poor prognosis. Therefore, multidisciplinary treatment strategy has been much investigated recently. This study investigated the efficacy of 3 dimensional conformal radiotherapy (3D-CRT) concurrent with Temozolomide chemotherapy in the treatment of postoperative cerebral gliomas. Methods: Sixty-two patients with cerebral glioma who had residual tumor surgery after surgery were randomized into 3D-CRT group (radiotherapy group, n=31) and 3D-CRT concurrent chemotherapy group (chemoradiotherapy group, n=31) prospectively. All patients received a dose of 50-60Gy/25-30F/5-6 weeks by 6MV-X ray, 1fx/day, 5 times a week. Chemotherapy regimen was Temozolomide: 75 mg/(m~2·d),concomitantly with radiotherapy,followed by 150-200mg/(m~2·d)for 5 days,28 days per cycle for total 3-6 cycles. Results: The total response rate was 35.3% (11/31) in the radiotherapy group, and 61.3% (19/31) in the chemoradiotherapy group. The difference was significant (P=0.042). But no significant difference was observed in terms of survival in the two groups (P=0.263). Stratified analysis showed that patients with grade Ⅲ gliomas in chemoradiotherapy group had better prognosis than those in the radiotherapy group (P=0.043). Conclusion. 3D-CRT concurrent with chemotherapy can improve the survival of pathological grade Ⅲ gliomas.