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放疗联合替莫唑胺同步治疗恶性胶质瘤的疗效观察

ACTA UNIVERSITATIS MEDICINALIS NANJING(2010)

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Abstract
目的:观察放疗联合替莫唑胺(TMZ)同步治疗恶性胶质瘤的疗效.方法:62例手术后恶性胶质瘤患者随机分成放疗联合TMZ同步治疗组(治疗组)和放疗联合替尼泊甙(VM-26)+甲环亚硝脲(Me-CCNU)组(对照组).治疗组30例(3级21例,4级9例),对照组32例(3级24例,4级8例).头颅常规放疗DT 60 Gy/30f/42 d,治疗组同时每天服用TMZ 75 mg/m2,直到放疗结束.随后用TMZ辅助化疗6疗程,150~200 mg/(m2·d)×5 d,每28天重复.对照组放疗后VM-26 70 mg/(m2·d)×3天,Me-CCNU 100~150 mg/(m2·d)×1天,每28天重复,连用6疗程.结果:治疗组1、2、3年生存率分别是73.3%(22/30)、33.3%(10/30)、6.7%(2/30),中位生存期20个月.对照组1、2、3年生存率分别是68.8%(22/32)、28.1%(9/32)、6.3%(2/32),中位生存期17个月.两组比较无显著差异(P>0.05).两组血液学毒性和放射性脑损伤症状可耐受.结论:放疗联合TMZ化疗提高了恶性胶质瘤的生存率,与放疗联合VM-26+Me-CCNU化疗相比,生存率差异无统计学意义.
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