中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2012年
5期
474-477
,共4页
陈怡东%房彤%蒋静%陈力%孙保锦%邱晓光
陳怡東%房彤%蔣靜%陳力%孫保錦%邱曉光
진이동%방동%장정%진력%손보금%구효광
胶质母细胞瘤,多形性%三维适形放疗%调强放疗%替莫唑胺
膠質母細胞瘤,多形性%三維適形放療%調彊放療%替莫唑胺
효질모세포류,다형성%삼유괄형방료%조강방료%체막서알
Glioblastoma,multiforme%Three -dimensional conformal radiotherpy%Intensity -modulated radiotherapy%Temozolomide
目的 探讨精确放疗同步替莫唑胺化疗对多形性胶质母细胞瘤的临床疗效.方法 回顾性分析2009年7月至2010年12月北京世纪坛医院收治的54例多形性胶质母细胞瘤,术后接受精确放疗(三维适形或调强放疗)同步替莫唑胺化疗,随后接受替莫唑胺辅助化疗.结果 全组共21例死亡,均死于肿瘤复发.全组1年总生存率为79.6％,1年无进展生存率为48.7％.32例出现复发,其中原位复发为16例.卡氏评分(KPS≥70分)组1年总生存率显著高于卡氏评分(KPS＜ 70分)组(86.8％与50.8％,P=0.005).全切或近全切除组1年总生存率高于部分切除组(84.4％与70.5％,P=0.067).仅2例出现3度以上不良反应(骨髓抑制).结论 精确放疗同步替莫唑胺化疗是多形性胶质母细胞瘤安全有效的治疗模式,卡氏评分和手术切除肿瘤的程度是影响生存的重要因素.
目的 探討精確放療同步替莫唑胺化療對多形性膠質母細胞瘤的臨床療效.方法 迴顧性分析2009年7月至2010年12月北京世紀罈醫院收治的54例多形性膠質母細胞瘤,術後接受精確放療(三維適形或調彊放療)同步替莫唑胺化療,隨後接受替莫唑胺輔助化療.結果 全組共21例死亡,均死于腫瘤複髮.全組1年總生存率為79.6％,1年無進展生存率為48.7％.32例齣現複髮,其中原位複髮為16例.卡氏評分(KPS≥70分)組1年總生存率顯著高于卡氏評分(KPS＜ 70分)組(86.8％與50.8％,P=0.005).全切或近全切除組1年總生存率高于部分切除組(84.4％與70.5％,P=0.067).僅2例齣現3度以上不良反應(骨髓抑製).結論 精確放療同步替莫唑胺化療是多形性膠質母細胞瘤安全有效的治療模式,卡氏評分和手術切除腫瘤的程度是影響生存的重要因素.
목적 탐토정학방료동보체막서알화료대다형성효질모세포류적림상료효.방법 회고성분석2009년7월지2010년12월북경세기단의원수치적54례다형성효질모세포류,술후접수정학방료(삼유괄형혹조강방료)동보체막서알화료,수후접수체막서알보조화료.결과 전조공21례사망,균사우종류복발.전조1년총생존솔위79.6％,1년무진전생존솔위48.7％.32례출현복발,기중원위복발위16례.잡씨평분(KPS≥70분)조1년총생존솔현저고우잡씨평분(KPS＜ 70분)조(86.8％여50.8％,P=0.005).전절혹근전절제조1년총생존솔고우부분절제조(84.4％여70.5％,P=0.067).부2례출현3도이상불량반응(골수억제).결론 정학방료동보체막서알화료시다형성효질모세포류안전유효적치료모식,잡씨평분화수술절제종류적정도시영향생존적중요인소.
Objective To investigate the clinical outcomes and toxicity for patients with glioblastoma multiforme (GBM) who underwent precise radiotherapy combined with temozolomide (TMZ).Methods The records of 54 patients with newly - diagnosed GBM from July 2009 to December 2010 were reviewed.The patients underwent postoperative intensity - modulated radiotherapy (IMRT) or three -dimensional conformal radiotherapy (3D -CRT) with concurrent and adjuvant TMZ.Results The median follow - up was 13 months.Of the 54 patients,50 completed the combined modality treatment.The overall survival rate was significantly different between patients with good performance status( KPS ≥70) and those with worse performance status ( KPS ＜ 70) ( 86.8％ VS.50.8％,P =O.005 ).Patients who underwent partial resection had lower overall survival rate compared with those who underwent total resection,but no reach statistically significant (84.4％ vs.70.5％,P =0.067).The pattern of failure was predominandy local. Grade 3 -4 toxicity was limited to 2 patient with leukopenia during concurrent chemoradiotherapy.Conclusions These results indicate that precise radiotherapy combined with TMZ is effective and safe treatment for GBM patients. Performance status and extent of surgery were prognostic factors for overall survival.
