CAJ | 학술논문

目的：观察替莫唑胺联合贝伐单抗同步放疗对高级别脑胶质瘤术后患者的临床效果及安全性。方法将我院2010年10月～2011年3月确诊的脑恶性胶质瘤患者84例随机分为治疗组和对照组，每组42例，两组患者均在手术后接受放射治疗，治疗组接受放疗的同时采用替莫唑胺与贝伐单抗联合治疗，对照组接受替尼泊苷联合洛莫司汀治疗。观察和比较两组患者的临床总有效率、疾病控制率、中位生存时间、3年生存率及不良反应的发生情况。结果治疗组和对照组的临床总有效率分别为88.1％、66.7％，疾病控制率分别为95.2％、81.0％，治疗组均显著高于对照组，差异均具有显著性（P<0.05）。治疗组的肝肾功能异常、消化道反应、骨髓抑制、疲乏的发生率均明显低于对照组（P<0.05）。治疗组的中位生存时间为30个月， 3年生存率为37.2％；对照组的中位生存时间21个月，3年生存率为13.0％，治疗组均显著优于对照组（P<0.05）。结论替莫唑胺联合贝伐单抗同步放疗治疗高级别脑胶质瘤的疗效优于替尼泊苷联合洛莫司汀，且不良反应更少，值得临床推广。
목적：관찰체막서알연합패벌단항동보방료대고급별뇌효질류술후환자적림상효과급안전성。방법장아원2010년10월～2011년3월학진적뇌악성효질류환자84례수궤분위치료조화대조조，매조42례，량조환자균재수술후접수방사치료，치료조접수방료적동시채용체막서알여패벌단항연합치료，대조조접수체니박감연합락막사정치료。관찰화비교량조환자적림상총유효솔、질병공제솔、중위생존시간、3년생존솔급불량반응적발생정황。결과치료조화대조조적림상총유효솔분별위88.1％、66.7％，질병공제솔분별위95.2％、81.0％，치료조균현저고우대조조，차이균구유현저성（P<0.05）。치료조적간신공능이상、소화도반응、골수억제、피핍적발생솔균명현저우대조조（P<0.05）。치료조적중위생존시간위30개월， 3년생존솔위37.2％；대조조적중위생존시간21개월，3년생존솔위13.0％，치료조균현저우우대조조（P<0.05）。결론체막서알연합패벌단항동보방료치료고급별뇌효질류적료효우우체니박감연합락막사정，차불량반응경소，치득림상추엄。
Objective To observe the clinical effect and safety of temozolomide plus avastin combined with concurrent radiotherapy on postoperative high-grade glioma. Methods A total of 84 patients with high-grade glioma who got surgery between October 2010 and March 2011 in our hospital were randomly divided into the treating group (n=42) and control group (n=42). All patients got radiotherapy after sur-gery. Meanwhile, patients in treating group got temozolomide and avastin, while patients in control group got teniposide and lomustine. The total effective rate, disease control rate (DCR), median survival time, 3-year survival rate and incidence of adverse reactions were observed and compared between two groups. Results The total effective rate of treating group (88.1%) was higher than that (66.7%) of the control group (P<0.05), and the DCR (95.2%) in the treating group was also significantly higher than that (81.0%) of the control group (P<0.05). The median survival time of treating group and control group were 30 months and 21 months respectively, and the 3-year survival rate was 37.2% and 13.0% respectively; the median survival time and 3-year survival rate were obviously better in the treating group(P<0.05). The incidence rates of hepatorenal dysfunction, gastrointestinal reactions, myelosuppression, fatigue of treating group were significantly lower than those of the control group (P<0.05). Conclusions Temozolomide plus avastin combined with concurrent radiotherapy had better clini-cal effect and fewer adverse reactions on postoperative high-grade glioma than teniposide plus lomustine, and so it was worth being pro-moted.