高分级脑胶质瘤术后同步放化疗联合辅助化疗的临床研究

摘要

Objective:To investigate the clinical effect of radiotherapy plus adjuvant chemotherapy on high grade postoperative gliomas. Methods:All 138 patients with high grade glioma operation were randomly divided into two groups. In control group,67 cases were treated with radiation therapy. The observation group of 71 cases,on the basis of the control,the concurrent chemotherapy and adjuvant chemotherapy were performed. All patients were followed -up for three years. Results:Patients in observation group with complete remission,partial remission,stability,progress and efficiency were 47. 89% ,40. 85% ,8. 45% ,2. 82% and 88. 73% ,in the control group were 28. 36% ,32. 84% , 13. 43% ,25. 37% and 61. 19% ,the observation group complete remission rate and the effective rate was significantly higher than that in the control group(P ﹤ 0. 05). In observation group patients after one year,two years,three years survival rates were 91. 55% ,69. 01% and 50. 70% ,the control group were 50. 75% ,16. 42% and 10. 45%(P ﹤ 0. 05). The patients in the observation group developed nausea and vomiting,neutropeniaand thrombocytopenia were respectively 63. 38% ,49. 30% and 52. 11% ,the control group were 62. 69% ,46. 27% and 52. 24% ,there was no significant difference between the two groups. Conclusion:Patients after operation with high grade gliomas treated by concurrent chemoradiotherapy plus adjuvant chemotherapy can effectively improve outcomes improve the prognosis without increasing adverse reactions.%目的：探讨高分级脑胶质瘤术后同步放化疗联合辅助化疗的临床效果。方法：选取高分级脑胶质瘤手术患者138例，随机分为两组，使其具有可比性。对照组67例，给予单纯放射治疗。观察组71例，在对照组基础上给予同步化疗和辅助化疗。对两组患者治疗效果进行统计。随访三年，记录三年期间生存率。结果：观察组患者完全缓解、部分缓解、稳定、进展和有效率分别为47.89％、40.85％、8.45％、2.82％和88.73％，对照组分别为28.36％、32.84％、13.43％、25.37％和61.19％，观察组患者完全缓解率和有效率均明显高于对照组，两组比较差异有统计学意义（P ﹤0.05）。观察组患者术后一年、两年、三年生存率分别为91.55％、69.01％和50.70％，对照组分别为50.75％、16.42％和10.45％，观察组明显高于对照组，两组比较差异有统计学意义（P ﹤0.05）。观察组患者发生恶心呕吐、中性粒细胞下降以及血小板减少者分别占63.38％、49.30％和52.11％，对照组分别为62.69％、46.27％和52.24％，两组比较差异无统计学意义。结论：高分级脑胶质瘤患者在术后进行同步放化疗联合辅助化疗可以有效提高患者的治疗效果，改善患者预后，不会增加不良反应，因此是一种安全而有效的治疗方案。