%0 Journal Article
%T 替莫唑胺联合放疗治疗高级别脑胶质瘤的临床分析
%A 吴事海
%A 周亚燕
%A 徐钢
%A 李先明
%A 李壮玲
%A 李子煌
%A 杨东
%J 肿瘤防治研究
%D 2015
%R 10.3971/j.issn.1000-8578.2015.02.019
%X 摘要 目的 观察替莫唑胺(temozolomide, TMZ)联合放疗治疗高级别脑胶质瘤（high-grade glioma, HGG）患者的疗效和安全性，探讨影响HGG患者预后的因素。方法 回顾性分析50例采用TMZ联合放疗治疗初诊HGG患者临床资料。采用三维适形或调强放疗治疗，患者放疗期间均同步口服TMZ，剂量为75 mg/（m2·d） ；放化疗结束后，再行TMZ辅助化疗，方案为（150~200）mg/（m2·d），连续服用5天，28天为1周期。观察患者的疗效及安全性，并对患者性别、年龄、KPS评分、手术切除程度、病理分级、手术至放疗开始间隔时间、放疗技术及TMZ辅助化疗周期数等因素对患者预后的影响进行多因素分析。结果 全组患者中位随访时间为21.4月（6.6~57.5月），28例患者出现肿瘤进展或复发，22例患者死亡；全组1、2和3年总生存率（OS）和无进展生存率（PFS）分别为85.8%和71.8%、54.9%和44.2%及51.2%和44.2%。服用TMZ期间常见不良反应为恶心、呕吐，并伴有中性粒细胞及血小板的减少，但大多数患者均能耐受。多因素分析显示KPS评分、病理分级及辅助化疗周期数是影响OS的独立预后因素；手术切除程度、病理分级及辅助化疗周期数是影响PFS的独立预后因素。结论 TMZ联合放疗治疗初诊HGG疗效肯定，安全性较好。KPS评分、手术方式、病理分级及辅助化疗周期数是影响患者预后的重要预后因素
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%U http://www.zlfzyj.com/CN/abstract/abstract8427.shtml