低剂量替莫唑胺联合放疗脑转移瘤的疗效

目的研究低剂量替莫唑胺联合放疗脑转移瘤相对于单纯放疗的临床有效性和安全性。方法将60例脑转移瘤患者随机分为单纯放疗(放疗组30例)和放疗+替莫唑胺联合(联合组30例)。放疗组:全脑放疗剂量总剂量3000 cGy/(10 F·14 d);联合组:放疗方法与放疗组相同,放疗第1天开始同步给药替莫唑胺75 mg/(m2·d),连用14 d。结果放疗组和联合组近期有效分别为16例(53.3.0%)和23例(76.7%),部分缓解分别为11例(36.7%)和17例(56.7%),进展分别为8例(26.7%)和2例(6.7%),差异均有统计学意义(P0.05);治疗后中位生存时间放疗组为5.0个月,联合组为8.5个月,2组比较,差异无统计学意义(P0.05);联合组胃肠道反应高于放疗组,但患者均能耐受。结论脑转移瘤患者行低剂量替莫唑胺联合放疗可以提高缓解率,适度延长生存时间,耐受性良好。

Efficacy of low-dose temozolomide combined with radiotherapy for patients with brain metastatic tumor

Objective To investigate the efficacy and safety of lose-dose temozolomide combined with radiotherapy for patients with brain metastatic tumor. Methods Sixty patients with brain metastatic tumor were divided into radiotherapy group（30 cases） and combined group（30 cases） randomly. The radiotherapy group was given whole brain radiotherapy（WBRT） with dose of DT 3000 cGy/（10 F·14 d）. The combined group was given the same radiotherapy synchronously administered temozolomide 75 mg/（m^2· d） for 14 days. Results For radiotherapy group and combined group,the recent response rates were 53.3.0%（16/30） and 76.7%（23/30）,partial remission rates 36.7%（11/30） and 56.7%（17/30）,progression rates 26.7%（8/30） and 6.7%（2/30）,respectively. All the results above had significant differences（P〈 0.05） between the two groups. There were no significant differences in median survival time for radiotherapy group and combined group（5 months vs 8.5 months,P 〉0.05）. The gastrointestinal reactions were higher in the combined group than those in the radiotherapy group,but all the patients were tolerated. Conclusion Lowdose temozolomide combined with radiotherapy can raise the remission rate,prolong survival time,and have good tolerance for patients with brain metastatic tumor.