CAJ | 학술논문

目的：观察脑胶质瘤术后放疗联合替莫唑胺（TMZ）与放疗联合尼莫司汀（ACNU）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患者36例，根据患者的意愿及经济情况分为放疗联合替莫唑胺组（RT-TMZ组）18例与放疗联合尼莫司汀组（RT-ACNU组）18例，分别应用替莫唑胺（TMZ）和尼莫司汀（ACNU）化疗4～6个周期。同时进行放疗，总照射剂量60Gy，2Gy/次，1次/d，5次/周。结果两组患者观察期内均未出现Ⅲ度以上毒性反应，RT-TMZ组的I～Ⅱ度不良反应发生率较RT-ACNU组为低（P＜0.05）。RT-TMZ组有效率、控制率（83.3％，88.9％）均明显高于RT-ACNU组（55.6％，66.7％），两组差异具统计学意义（P＜0.05）。RT-TMZ组的中1、2年生存率分别为77.8％、55.6％，优于RT-ACNU组的61.1％、33.3％（P＜O.05）。结论与放疗联合ACNU组相比，放疗联合TMZ联合组对脑胶质瘤术后患者更安全、有效。脑恶性胶质瘤患者术后放疗联合TMZ化疗疗效较好，毒副作用较轻，且TMZ口服应用方便，有较好的临床应用前景。
목적：관찰뇌효질류술후방료연합체막서알（TMZ）여방료연합니막사정（ACNU）적근기료효급안전성。방법경수술후병리학진적고급별뇌효질류환자36례，근거환자적의원급경제정황분위방료연합체막서알조（RT-TMZ조）18례여방료연합니막사정조（RT-ACNU조）18례，분별응용체막서알（TMZ）화니막사정（ACNU）화료4～6개주기。동시진행방료，총조사제량60Gy，2Gy/차，1차/d，5차/주。결과량조환자관찰기내균미출현Ⅲ도이상독성반응，RT-TMZ조적I～Ⅱ도불량반응발생솔교RT-ACNU조위저（P＜0.05）。RT-TMZ조유효솔、공제솔（83.3％，88.9％）균명현고우RT-ACNU조（55.6％，66.7％），량조차이구통계학의의（P＜0.05）。RT-TMZ조적중1、2년생존솔분별위77.8％、55.6％，우우RT-ACNU조적61.1％、33.3％（P＜O.05）。결론여방료연합ACNU조상비，방료연합TMZ연합조대뇌효질류술후환자경안전、유효。뇌악성효질류환자술후방료연합TMZ화료료효교호，독부작용교경，차TMZ구복응용방편，유교호적림상응용전경。
Objective To observe the short-term efficacy and safety of radiotherapy combined with temozolomide(TMZ) and radiotherapy combined with nimustine(ACNU) after the surgery for glioma. Methods Thirty-six patients with high grade glioma diagnosed by postoperative pathological report were divided into 18 cases of the radiotherapy combined with temozolomide treatment group(RT-TMZ group) and 18 cases of the radiotherapy combined with nimustine treatment group(RT-ACNU group) according to the patient's wishes and economic situation. The patients in two groups were applied temozolomide(TMZ) or nimustine(ACNU) for 4 ~ 6 cycles of chemotherapy respectively, meanwhile implemented radiotherapy with 60Gy total exposure dose, 2Gy every time, once a day, 5 times every week. Results The patients in two groups did not appear aboveⅢdegrees toxic reactions during the observation period, the incidence of I~Ⅱ degree adverse reactions in the RT-TMZ group was lower than that in the RT-ACNU group(P < 0.05). The effective rate and control rate in the RT-TMZ group(83.3%, 88.9%) were significantly higher than those in the RT-ACNU group(55.6%,66.7%), and the differences were statistically significant between two groups(P<0.05). The 1 year and 2 years survival rate in the RT-TMZ group(77.8%, 55.6%respectively) were superior to those in the RT-ACNU group(61.1%, 33.3%respectively),P<0.05. Conclusion Compared with the radiotherapy combined with ACNU, the radiotherapy combined with TMZ after the surgery for patients with glioma is safer and more effective. The postoperative radiotherapy combined with TMZ for patients with malignant glioma has better efficacy, minor toxic reactions, and oral TMZ is easy to use, it will be good prospects for clinical application.