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目的回顾性分析并评价术后同步放化疗治疗高分级脑胶质瘤的疗效。方法 117例高分级脑胶质瘤患者术后随机分为观察组(58例)和对照组(59例)。对照组给予术后常规放疗,总剂量DT=60Gy/6周。观察组化疗与放疗同步进行。在脑部放疗20～30Gy时,口服司莫司汀(Me-CCNU)150mg,放疗期间每周一次,共3～4次,放疗结束后每6～8周一次,共6～8次。结果局部近期疗效观察组和对照组有效率分别为68.97%和25.42%,两者比较差异有统计学意义(P<0.01)。中位复发时间观察组和对照组分为14.25个月和10.38个月(P<0.01)。1、2、3、4年生存率观察组和对照组分别为72.41%、43.10%、22.41%、12.09%和49.15%、15.25%、10.17%、1.69%。经统计分析,2年生存率差异有统计学意义(P<0.05)。观察组急性反应加重,远期损伤两组相近。结论术后同步放化疗能提高高分级脑胶质瘤患者局部控制率,延长复发时间,并可提高生存率。
Objective To retrospectively analyze and evaluate the efficacy of concurrent chemoradiotherapy in the treatment of high grade gliomas. Methods 117 patients with high grade glioma were randomly divided into observation group (58 cases) and control group (59 cases). Control group was given conventional radiotherapy, the total dose of DT = 60Gy / 6 weeks. Observation group chemotherapy and radiotherapy simultaneously. In brain irradiation 20 ~ 30Gy, oral semustine (Me-CCNU) 150mg, once a week during radiotherapy, a total of 3 to 4 times, once every 6 to 8 weeks after radiotherapy, a total of 6 to 8 times. Results The effective rates of local short-term curative effect observation group and control group were 68.97% and 25.42% respectively, with significant difference between the two groups (P <0.01). The median recurrence time was 14.25 months in the observation group and 10.38 months in the control group (P <0.01). The survival rates of 1, 2, 3 and 4 years in observation and control groups were 72.41%, 43.10%, 22.41%, 12.09% and 49.15%, 15.25%, 10.17% and 1.69% respectively. The statistical analysis, 2-year survival rate difference was statistically significant (P <0.05). The acute reaction in the observation group aggravated, and the long-term injury was similar in both groups. Conclusions Concurrent concurrent chemoradiotherapy can improve the local control rate, prolong the recurrence time and improve the survival rate in patients with high grade glioma.