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顺铂联合替莫唑胺及同期放疗治疗术后胶质母细胞瘤
卢喜卫1,2,3
1.(1)西安交通大学第一附属医院神经外科,陕西 西安 710061;2)陕西省森林工业职工医院神经外科,陕西 户县 710300;3) 昆明医科大学药学院暨云南省天然药物药理重点实验室,云南 昆明 650500)
摘要:
[摘要]目的 评估顺铂联合替莫唑胺及同期放疗在治疗脑胶质母细胞瘤术后中的效果.方法 脑胶质母细胞瘤患者68例,按治疗方式分成对照组(n=36例)和处理组(n=32例).对照组患者术后给予替莫唑胺联合放疗;处理组患者除了给予替莫唑胺和放疗之外加用顺铂.对2组患者进行随访,从近期疗效、不良反应和生存期3个方面对比评估顺铂联合替莫唑胺及同期放疗在胶质母细胞瘤治疗中的效果.结果 处理组治疗近期有效率(87.5%)显著高于对照组(66.67%),P<0.05.2组患者不良反应:处理组骨髓抑制、神经精神症、消化道症状发生率与对照组差异无统计学意义(P>0.05).随访结果显示:处理组中位生存期(26月)显著长于对照组(17.5月),P<0.05;2组生存率比较,处理组1 a生存率(81.25%)与对照组(63.89%)差异无统计学意义(P>0.05);2、3 a生存率处理组(52.13%, 31.25%)显著高于对照组(27.78%, 11.11%),P<0.05;患者1 a期无疾病进展(PFS)率处理组(68.75%)显著高于对照组(41.67%),P<0.05.结论 顺铂联合替莫唑胺及同步放疗能够显著提高胶质母细胞瘤患者患者治疗效率,不良反应与对照组相当,能显著改善胶质母细胞瘤2、3 a生存率及1 a期无疾病进展(PFS)率,值得在临床上进行推广应用.
关键词:  [关键词]胶质母细胞瘤  顺铂  替莫唑胺  放疗  疗效
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基金项目:[基金项目]云南省天然药物药理重点实验室开放基金资助项目(2015G011);云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(2013FB111)
Clinical Effects of Cisplatin Combined with Temozolomide and Radiotherapy in Treatment of Glioblastomas after Surgery
LU Xi-wei1,2,3
1.(1)Dept. of Neurosurgery,The First Affiliated Hospital,Medical School of Xi’an Jiaotong University, Xi’an Shaanxi 710061;2)Dept. of Neurosurgery,Shaanxi Sengong Hospital,Huxian Shaanxi 710300;3)School of Pharmaceutical Science & Yunnan Key Laboratory of Pharmacology for Natural Products,Kunming Yunnan 650500,China)
Abstract:
[Abstract]Objective To investigate the clinical effect of cisplatin combined with cisplatin and radiotherapy in the treatment of glioblastomas patients receiving surgery. Methods 68 cases of glioblastomas patients with surgery were divided into control group(n=36) and treatment group(n=32). The control group was treated with temozolomide and radiotherapy;the treatment group was treated with cisplatin combined with temozolomide and radiotherapy. Short-term efficacy, adverse reactions, and survival time were documented during following up in both groups. Results The efficiency in the treatment group (87.5%) was significantly higher than that in the control group (66.67%),P<0.05. There were no significant difference of adverse reaction including bone marrow inhibition, digestive tract symptoms, and psychiatric symptoms among the two groups,P>0.05. The medium survival time of the treatment group (26.0 month) was significantly longer than that of the control group (17.5 month), P<0.05. There was no significant difference of 1-year survival rate between the treatment group (81.25%) with control group (63.89%), P>0.05; however, 2- and 3-year survival rate in treatment group (52.13%, 31.25%) were significantly higher than that in the control group(27.78%,11.11%),P<0.05. 1-year progression free survival (PFS) rate of treatment group (68.75%) was significantly higher that of control group (41.67%),P<0.05. Conclusion Cisplatin combined with temozolomide and radiotherapy can significantly improve the treatment efficiency without leading to higher rate of adverse reactions and significantly improve the 2-, 3-year survival rate as well as 1-year progression free survival(PFS)rate in patients with glioblastomas,it is worth being promoted in clinical application.
Key words:  [Key words]Glioblastomas  Cisplatin  Temozolomide  Radiotherapy  Efficacy