立体定向放射治疗联合替莫唑胺治疗复发性脑胶质瘤的疗效

目的:探究立体定向放射治疗联合替莫唑胺治疗复发性脑胶质瘤的临床疗效。方法:纳入2013年01月至2016年03月我院肿瘤科收治的43例复发性脑胶质瘤患者临床资料，所有入组患者均符合脑胶质瘤诊断标准，复发后经磁共振成像（MRI）影像学检查均诊断为原发肿瘤体积增大或出现新发肿瘤病灶；根据随机法将所有入组患者进行分组，对照组20例，行单纯立体定向放射治疗(SRT)；观察组23例，行SRT＋替莫唑胺治疗(TMZ)。将所得数据录入SPSS 17.0统计软件进行分析，观察对比两组患者近期临床疗效、生活质量改善情况及治疗后出现不良反应的发生率，采用Kaplan-Meier法分析两组患者2年内累积生存情况，观察组间差异是否具有统计学意义。α=0.05为检验标准。结果:观察组患者近期临床疗效整体优于对照组，有效率及局部控制率均显著高于对照组（P＜0.05）。观察组患者治疗后生活质量改善情况高于对照组（95.65％ vs 80.00％）。观察组患者的中位生存期为12个月（95%CI:7.802~12.963），对照组患者的中位生存期为9个月（95%CI:5.019~9.689），两组中位生存期组间差异有统计学意义（P＜0.05）。两组患者治疗后不良反应的总发生率无显著差异（40.00％ vs 43.48％，P＞0.05）。结论:立体定向放射治疗联合替莫唑胺治疗复发性脑胶质瘤疗效显著、安全，对提高患者生存率有积极影响。

Efficacy of stereotactic radiotherapy combined with temozolomide in the treatment of recurrent glioma

Objective:To explore the clinical effect of stereotactic radiotherapy combined with temozolomide in the treatment of recurrent glioma.Methods:The clinical data of 43 patients with recurrent glioma admitted to the oncology department of our hospital from January 2013 to March 2016 were included.All the enrolled patients met the diagnostic criteria for glioma.After recurrence,all the patients were diagnosed with increased primary tumor volume or new tumor lesions by magnetic resonance imaging (MRI) examination.According to the randomized method,all patients were divided into groups.The control group received 20 cases of stereotactic radiotherapy (SRT).In the observation group,23 patients were treated with SRT+temozolomide (TMZ).The data were input into SPSS 17.0 statistical software for analysis,and the short-term clinical efficacy,quality of life improvement and incidence of adverse reactions after treatment were observed and compared between the two groups.Kaplan-Meier method was used to analyze the cumulative survival of patients in the two groups within 2 years,and to observe whether the differences between the groups were statistically significant.α=0.05 was the test standard.Results:The short-term clinical efficacy of the observation group was better than that of the control group,and the effective rate and local control rate were significantly higher than those of the control group (P＜0.05).The improvement of quality of life in the observation group was higher than that in the control group (95.65% vs 80.00%).The median survival time of patients in the observation group was 12 months (95%CI:7.802~12.963),and that of patients in the control group was 9 months (95%CI:5.019~9.689),showing statistically significant differences between the two groups (P＜0.05).There was no significant difference in the total incidence of adverse reactions after treatment between the two groups (40.00% vs 43.48%,P＞0.05).Conclusion:Stereotactic radiotherapy combined with temozolomide in the treatment of recurrent glioma is effective and safe,and has a positive effect on the survival rate of patients.