替莫唑胺与洛莫司汀治疗脑胶质瘤的临床观察

doi:10.3971/j.issn.1000-8578.2860

替莫唑胺与洛莫司汀治疗脑胶质瘤的临床观察

Clinical Observation of Temozolomide and Lomustine in Treating with Gliomas

摘要

摘要: 目的比较替莫唑胺（TMZ）与洛莫司汀（CCNU）治疗脑胶质瘤的疗效、生存期及不良反应。方法 64例首次术后脑胶质瘤患者随机分为TMZ组和CCNU组各32例，两组患者先给予常规放疗，2Gy/d，5d/W，共持续4～6W，射线总剂量50～60Gy。放疗结束后1周开始化疗。TMZ组口服TMZ（0.015～0.02）mg/(cm2·d)，5d/W，每5天为1个疗程，每疗程间隔23天，28天为1个治疗周期，根据患者耐受情况给药3～5个周期。CCNU组口服CCNU(0.005～0.006)mg/(cm2·d)，5d/W，疗程和治疗周期同TMZ组。结果 TMZ组疗效明显优于CCNU组（U=1.9675，P=0.0245）；TMZ组平均生存期（14.5±2.5）月，明显高于CCNU组（10.5±1.5）月（t=7.7611，P=0.000）；TMZ组恶心、呕吐、乏力的发生率明显低于CCNU组（χ2=4.0635，P=0.0437）；TMZ组骨髓抑制程度明显低于CCNU组（U=3.2314，P=0.0006）。结论 TMZ比CCNU更明显地缩小肿瘤体积，延长患者的生存期，副作用少，提高患者的生活质量，值得临床推广应用。

Abstract: Objective To compare the therapeutic effect,survival and safety of temozolomide(TMZ) and lomustine(CCNU) on glioma. Methods A total of 64 postoperative patients with glioma were randomly divided into two groups:TMZ treatment and CCNU treatment group.All patients were performed conventional radiotherapy, 2Gy/d，5d/W，4～6 weeks as a treatment course，for a total of 50～60Gy. After radiotherapy,TMZ group were treated with TMZ (0.015～0.02)mg/(cm2·d) by orally for 5 days during 28-day cycle.CCNU group were treated with CCNU(0.005～0.006)mg/(cm2·d) by orally for 5 days during 28-day cycle. Results The effect in TMZ group were superior to CCNU group（U=1.9675，P=0.0245）；the average survival time of patients in TMZ group were longer than that of in CCNU group（t=7.7611，P=0.000）；the happening rate of nausea,vomitting and tired in TMZ group was lower than that in CCNU group（χ2=4.0635，P=0.0437）；The myelotoxicity in TMZ group were slighter than that in CCNU group（U=3.2314，P=0.0006）. Conclusion TMZ can improve the patients with gliomas in the symptoms and survival quality better,and produce higher response rate compared to CCNU in patients with gliomas.

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