CAJ | 학술논문

目的：探讨替莫唑胺联合放疗同步治疗胶质母细胞瘤的疗效观察。方法回顾性分析自2008年1月~2014年1月我科收治的64例经术后病例证实的胶质母细胞瘤患者，其中39例采用术后放疗+替莫唑胺同步化疗（同步组），25例采用术后放疗+替莫唑胺序贯化疗（序贯组）。比较两组1年和3年生存率、客观有效率及毒副作用。结果随访6个月~3年，同步组患者1年和3年生存率分别为74.4%和38.5%，序贯组1年和3年生存率分别为64.0%和28.0%，两组差异有统计学意义（P<0.05）；同步组和序贯组客观有效率分别是64.1%和44.0%，差异有统计学意义（P<0.05）；同步组和序贯组胃肠道反应发生率分别为23.1%和20.0%，差异无统计学意义（P>0.05），其他毒副反应发生率差异有统计学意义（P<0.05）。结论替莫唑胺同步化疗治疗胶质母细胞瘤疗效较序贯性化疗显著，尽管毒副作用临床表现较序贯组有所加重，仍应是治疗胶质母细胞瘤的首选治疗方法。
목적：탐토체막서알연합방료동보치료효질모세포류적료효관찰。방법회고성분석자2008년1월~2014년1월아과수치적64례경술후병예증실적효질모세포류환자，기중39례채용술후방료+체막서알동보화료（동보조），25례채용술후방료+체막서알서관화료（서관조）。비교량조1년화3년생존솔、객관유효솔급독부작용。결과수방6개월~3년，동보조환자1년화3년생존솔분별위74.4%화38.5%，서관조1년화3년생존솔분별위64.0%화28.0%，량조차이유통계학의의（P<0.05）；동보조화서관조객관유효솔분별시64.1%화44.0%，차이유통계학의의（P<0.05）；동보조화서관조위장도반응발생솔분별위23.1%화20.0%，차이무통계학의의（P>0.05），기타독부반응발생솔차이유통계학의의（P<0.05）。결론체막서알동보화료치료효질모세포류료효교서관성화료현저，진관독부작용림상표현교서관조유소가중，잉응시치료효질모세포류적수선치료방법。
Objective To observe the clinical effect of temozolomide combined with radiotherapy in the treatment of malignant gliomas. Methods A total of 64 patients with pathologically confirmed glioblastoma received radiotherapy combined with chemotherapy in our hospital from January 2008 to January 2014, radiotherapy synchronized with TMZ chemotherapy were used in 39 patients (synchronized group) and radiotherapy sequential with TMZ chemotherapy in 25 patients (sequential group).1 year and 3 year survival rates, response rate and drug safety were compared between the two groups. Results The patients were followed up for 6 months to 3 years, the synchronous group of patients 1 years and 3 years survival rates (74.4%, 38.5%) were higher than the sequential group(64.0%, 28.0%) (P<0.05), objective re-sponse rate of two groups were 64.1%and 44.0%, the difference was statistically significant(P<0.05), gastrointestinal re-action rates of two groups were 23.1% and 20.0%, the difference was not statistically significant (P>0.05). Adverse re-actions were statistically significant (P<0.05). Conclusion The effect of radiotherapy synchronized combined with TMZ chemotherapy is better than radiotherapy sequential with TMZ chemotherapy for glioblastoma, it is still the first choice for the treatment of glioblastoma although the clinical manifestations of toxicity increased than the sequential group.