Objective To study the efficacy of whole brain radiotherapy combined with temozolomide concurrent chemo -therapy in the treatment of brain metastases .Methods 160 patients with brain metastases were randomly divided into the control group and the observation group ,80 cases in each.The control group received whole brain radiotherapy treatment .6mV-X line of whole brain radiation therapy was used ,both sides of the whole brain radiation therapy centers and other wear wild ,DT 30 Gy/10, 5 times/week.The observation group received temozolomide 75 mg/m2/d for treatment on the basis of whole brain radiation thera-py,based on continuous oral 14 d treatment.Side effects,near and long-term efficacy of treatment in the 2 groups were observed . Results In the observation group ,total effective rate was 87.50%,which was significantly higher than 53.75% of the control group.There was no significant difference (P>0.05) between the 2 groups in 3-month survival;6-month and 1-year survival rates of the observation group was significantly higher than the control group (P<0.05).Median survival time of the observation group was significantly better than the control group (11.8 v.s.6.4,P<0.05).Treatment of patients in both groups had no seri-ous side effects which can not be tolerated (Ⅳgrade);in white blood cells,hemoglobin and platelets of bone marrow suppression indicators,incidence of side effects in the observation group was significantly higher than the control group ,but after symptomatic treatment,the patients can be tolerated;the incidence of side effects and grade distribution of nausea ,vomiting and headache of the 2 groups no significant difference (P<0.05) two groups of patients.Conclusion The whole brain radiotherapy in combination with temozolomide treatment of brain metastases ,can significantly improve patients 'overall response rate ,and can significantly in-crease the survival time and survival rate of patients ,without increasing the incidence of side effects ,it is worthy of clinical recom-mendation .%目的 探讨联合使用全脑放疗和替莫唑胺治疗脑转移瘤的疗效.方法 将160例脑转移瘤患者随机分为对照组和观察组,每组各80例.对照组使用全脑放疗进行治疗.使用6mV-X线全脑放射治疗,全脑两侧对穿野等中心放射治疗,DT 30 Gy/10次,5次/周.观察组在全脑放射治疗的基础上使用替莫唑胺75 mg/m2/d进行治疗,连续口服14 d进行.观察2组患者治疗后的近远期疗效以及治疗过程中出现的副作用.结果 观察组总有效率为87.50%,显著高于对照组中的53.75%.对照组和观察组在3个月的生存期上没有统计学差异(P>0.05);在6个月生存率和1年生存率上,观察组显著高于对照组(P<0.05).中位生存期的比较上,观察组显著优于对照组(11.8 v.s.6.4,P<0.05).2组患者治疗过程中均没有出现无法耐受的严重副作用(Ⅳ级);在白细胞、血红蛋白和血小板等骨髓抑制的指标中,观察组出现副作用的发生率显著高于对照组,但是经过对症治疗后,患者均可以耐受;在恶心呕吐和头疼的副作用发生率和等级分布上,2组患者没有统计学差异(P>0.05).结论 全脑放疗联合使用替莫唑胺治疗脑转移瘤,可以显著提高患者总的缓解率,并能够显著延长患者的生存期和提高生存率,且副作用均可耐受,值得临床推荐使用.
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