| 沙利度胺联合替莫唑胺及放疗治疗高级别脑胶质瘤术后残余病灶的临床观察 |
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| 引用本文： | 徐利本,吴朝阳,王远东,王 燕. 沙利度胺联合替莫唑胺及放疗治疗高级别脑胶质瘤术后残余病灶的临床观察[J]. 现代肿瘤医学, 2020, 0(2): 219-223. DOI: 10.3969/j.issn.1672-4992.2020.02.009 |
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| 作者姓名： | 徐利本 吴朝阳 王远东 王 燕 |
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| 作者单位： | 江苏大学附属人民医院放疗科，江苏 镇江 212000 |
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| 基金项目： | 2018年度镇江市社会发展指导性项目（编号:FZ2018034）;江苏大学2018年度临床医学科技发展基金（编号:JLY20180001） |
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| 摘 要： | 目的:探索沙利度胺联合替莫唑胺及调强放疗对高级别脑胶质瘤术后残余病灶的临床疗效、安全性及对生活质量的影响。方法:回顾性分析我院高级别脑胶质瘤术后残余病灶患者60例，每组30例；对照组为调强放疗+替莫唑胺，观察组为调强放疗+替莫唑胺+沙利度胺，分析两组临床有效率、疾病控制率、不良反应及安全性、1年及2年PFS、OS。结果:对照组CR 3例，PR 10例，SD 12例，PD 5例；观察组CR 6例，PR 15例，SD 8例，PD 1例。RR:对照组43.33％，观察组70.00％（P=0.037)，DCR:对照组83.33％，观察组96.67％（P=0.085)；不良反应表现为I-II度骨髓抑制及肝功能异常（P＞0.05），对照组与观察组恶心呕吐发生率为56.67%与26.67%(P=0.018)，观察组嗜睡、便秘发生率为16.67%、36.67%，而对照组为0、13.33%（P=0.02/P=0.037)；观察组与对照组KPS评分提高率为60.00％与33.33％，KPS评分下降率为10.00％与30.00％（P=0.038/P=0.028)；对照组和观察组1、2年OS为43.3%、16.3%和73.3%、33.7%，中位OS为12个月和15个月(P=0.046)。1、2年PFS为31%、3.9%和48.9%、7.8%，中位PFS为8个月和12个月(P=0.025)。结论:沙利度胺联合替莫唑胺同步调强放疗治疗高级别脑胶质瘤术后残余病灶的疗效优于对照组，不良反应少，安全有效，可耐受，改善生活质量，值得进一步研究。
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| 关 键 词： | 沙利度胺 高级别脑胶质瘤 治疗效果 安全性 |
Clinical efficacy of thalidomide combined with temozolomide and radiation therapy in the treatment of residual lesions after high-grade glioma surgery |
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| Xu Liben,Wu Chaoyang,Wang Yuandong,Wang Yan. Clinical efficacy of thalidomide combined with temozolomide and radiation therapy in the treatment of residual lesions after high-grade glioma surgery[J]. Journal of Modern Oncology, 2020, 0(2): 219-223. DOI: 10.3969/j.issn.1672-4992.2020.02.009 |
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| Authors: | Xu Liben Wu Chaoyang Wang Yuandong Wang Yan |
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| Affiliation: | Department of Radiotherapy,the Affiliated People's Hospital of Jiangsu University,Jiangsu Zhenjiang 212000,China. |
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| Abstract: | Objective:To explore the clinical efficacy and safety of thalidomide combined with temozolomide and intensity modulated radiation (IMRT) in the treatment of residual lesions after high-grade glioma surgery.Methods:A retrospective analysis was made on 60 patients with residual lesions after high-grade glioma surgery in our hospital,30 in each group respectively.The control group was intensity modulated radiotherapy and mozolomide,while the observation group was intensity modulated radiotherapy plus temozolomide and thalidomide.The clinical effective rate,disease control rate,adverse reactions and safety,1 year and 2 years PFS/OS of two groups were analyzed.Results:There were 3 cases of complete response (CR),10 cases of partial response (PR),12 cases of stable disease (SD),5 cases of progression of disease (PD) in the control group.There were 6 cases of complete response (CR),15 cases of partial response (PR),8 cases of stable disease (SD),1 case of progression of disease (PD) in the observation group.RR was 43.33% in the control group,70.00% in the observation group (P=0.037).DCR was 83.33% in the control group,96.67% in the observation group (P=0.085).The main adverse reactions included I-II degree myelosuppression and abnormal liver function (P＞0.05).The incidence of nausea and vomiting in control group and observation group were 56.67% and 26.67% (P=0.018).The incidence of sleepiness and constipation in the observation group was 16.67% and 36.67%,while that in the control group was 0 and 13.33% (P=0.02/P=0.037).The improvement rate of KPS score in observation group and control group was 60.00%,33.33%,and the decrease rate of KPS score was 10.00% and 30.00% (P=0.038/P=0.028).The OS of control group and observation group was 43.3%,16.3%,73.3% and 33.7% in 1 and 2 years,and the median OS was 12 months and 15 months (P=0.046).The PFS was 31%,3.9% and 48.9%,7.8% in 1 and 2 years.The median PFS was 8 months and 12 months (P=0.025).Conclusion:Thalidomide combined with temozolomide intensity modulated radiation therapy is superior to the control group in the treatment of residual lesions after high-grade glioma surgery.It is safe,effective,tolerable and worthy of further study. |
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| Keywords: | thalidomide high-grade glioma efficacy safety |
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