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成人Ⅱ级以上脑胶质瘤术后同步放化疗疗效分析[J]. 肿瘤防治研究, 2007, 34(08): 626-628. DOI: 10.3971/j.issn.1000-8578.1395
引用本文: 成人Ⅱ级以上脑胶质瘤术后同步放化疗疗效分析[J]. 肿瘤防治研究, 2007, 34(08): 626-628. DOI: 10.3971/j.issn.1000-8578.1395
Effect of Postoperative Radiotherapy Concurrent Chemotherapy on Adult Patients with Grade Ⅱ~ ⅣCerebral Gliomas[J]. Cancer Research on Prevention and Treatment, 2007, 34(08): 626-628. DOI: 10.3971/j.issn.1000-8578.1395
Citation: Effect of Postoperative Radiotherapy Concurrent Chemotherapy on Adult Patients with Grade Ⅱ~ ⅣCerebral Gliomas[J]. Cancer Research on Prevention and Treatment, 2007, 34(08): 626-628. DOI: 10.3971/j.issn.1000-8578.1395

成人Ⅱ级以上脑胶质瘤术后同步放化疗疗效分析

Effect of Postoperative Radiotherapy Concurrent Chemotherapy on Adult Patients with Grade Ⅱ~ ⅣCerebral Gliomas

  • 摘要: 目的 前瞻性研究成人Ⅱ级以上脑胶质瘤患者术后同步放化疗的疗效。方法 1999年9月~2003年5月收治80例成人Ⅱ级以上脑胶质瘤术后患者,随机分成两组,各40例。①单纯放疗组,行单纯放疗,DT50~60Gy;②同步放化疗组,给予与单纯放疗组相同的放疗方法,同时于DT20Gy后行同步替尼泊甙(VM-26)联合司莫司汀(Me-CCNU)化疗,于放疗开始后4~6个月内完成4~6周期化疗。结果 后同步放化疗组1、3、5年生存率分别为85.00%、52.50%、30.00%,优于术后单纯放疗组的62.50%、27.50%、15.00%(χ2=5.07,P=0.024)。按不同病理分级进行比较,Ⅲ级脑胶质瘤同步放化疗的生存率明显优于单纯放疗(χ2=3.96,P=0.047),而Ⅱ级和Ⅳ级脑胶质瘤上述两种疗法的生存率无差异。结论 成人Ⅲ级脑胶质瘤患者术后外照射20Gy后行同步MV方案化疗,预后优于术后单纯放疗;对于Ⅳ级脑胶质瘤患者,其术后化疗方法以及放化疗结合方式仍需要探讨;成人Ⅱ级脑胶质瘤术后可以不必给予放化疗联合治疗。

     

    Abstract: Objective  To prospectively study the survival of adult patients with grade Ⅱ~ Ⅳcerebral gliomas received radiochemotherapy postoperatively. Methods  From sept . 1999 to may 2003, 80 adult postoperative patients with grade Ⅱ~ Ⅳcerebral gliomass were treated and divided into two groups randomly, each had 40 cases. One group (RT group) was irradiated with DT50~60 Gy merely and the other (RCT group) combined with chemotherapy(VM-26 and Me-CCNU) after DT20 Gy and 4~6 cycles of chemotherapy were delivered within 4~6 months. Results  The 1-, 3-, and 5- year survival rate of patients of RCT group was 85. 00 %、52. 50 %、30. 00 % while the survival rate of RT group was 62. 50 %、27. 50 %、15. 00 %, respectively. The difference of the survival rates between two groups was significant (χ2 = 5. 07, P = 0. 024) . Based on pathological grades, however, it was suggested that only the patients with grade Ⅲgliomas of RCT group had better prognosis than ones of RT group (χ2 = 3. 96, P = 0. 047) . The similar results were not found in patients with grade Ⅱor Ⅳgliomas. Conclusion  Given concurrent radiochemotherapy postoperatively, the survival could be improved in adult patients with grade Ⅲgliomas. And the data suggested that VM-26 combined with Me-CCNU should be an effective chemotherapeutic scheme. AS to grade Ⅳgliomas, more novel chemotherapeutic methods shoud be studied. The patients with grade Ⅱgliomas needn't receive chemotherapy besides postoperative radiotherapy.

     

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