脑胶质母细胞瘤放化疗疗效观察

目的观察并比较脑胶质母细胞瘤放疗加化疗与不加化疗的疗效。方法试验组28例患者放射治疗20～40Gy后，加用化疗药洛莫司汀(CCNU)或卡莫司汀(BCNU)；对照组28例单纯放射治疗20～40Gy，不加化疗药。结果经随访，试验组和对照组1，3，5年生存率分别为57.1%,22.5%,15.0%和17.9%,7.1%,3.6%,中位生存期分别为29.7±7.0个月和9.7±3.5个月，P＜0.001,差异有极显著性。显示试验组疗效优于对照组。结论脑瘤放疗20～40Gy后，血脑屏障开放，是化疗最佳时机，这期间加化疗，可显著提高生存率。

Therapeutic effect on glioblastoma of chemotherapy on the basis of brain irradiation

OBJECTIVE: To study the efficacy of chemotherapy for glioblastoma on the basis of brain irradiation. METHODS: It was previously reported that the permeability of the blood brain barrier (BBB) to methotrexate could be increased by brain irradiation. In this study, glioblastoma patients were divided into 2 groups, 28 patients in each group. On group of patients was treated with CCNU or BCNU after having given 20-40 Gy irradiation to the brain. The other group of patients received radiation treatment alone. RESULTS: The 1-, 3-, and 5-year survival rate of the two groups of patients was 57.1%, 22.5%, 15.0% and 17.9%, 7.1%, 3.6%, respectively. The median survival time was 29.7 +/- 7.0 and 9.7 +/- 3.5 months, respectively (P < 0.001). CONCLUSION: Increase in permeability of the BBB after 20-40 Gy brain irradiation may provide an optimal chance for intracranial chemotherapy of glioblastoma.