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目的探讨调强放疗(IMRT)联合替莫唑胺(TEM)药物治疗脑胶质瘤(BSG)术后残余病灶患者的临床疗效。方法选取2010年3月至2012年2月在我院接受手术治疗的BSG患者68例,随机分为两组。对照组患者术后给予IMRT;观察组患者术后在对照组基础上给予TEM药物治疗。两组患者均治疗6个周期,随访2年,对1年生存率、中位复发时间和中位生存时间以及治疗过程中的不良反应进行分析,在治疗结束后利用SF-36量表评估患者生活质量。结果观察组患者1年生存率、中位复发时间和中位生存时间分别为82.4%(28/34)、(22±4)个月和(24±4)个月,对照组为64.8%(22/34)、(12±4)个月和(18±4)个月,两组比较观察组明显优于对照组,差异均有统计学意义(P<0.05);治疗结束后,观察组患者的健康调查量表(SF-36)总得分明显高于对照组,差异有统计学意义(P<0.05);两组患者的骨髓抑制反应、胃肠道反应以及肝功能异常发生率相比,差异无统计学意义(P>0.05)。结论 IMRT联合TEM治疗能明显提升BSG术后残余病灶患者的生存率和存活时间,改善患者生存质量,且不增加不良反应。
Objective To investigate the clinical effect of IMRT combined with temozolomide (TEM) in the treatment of patients with residual lesion after glioma (BSG) surgery. Methods Sixty-eight patients with BSG undergoing surgery in our hospital from March 2010 to February 2012 were randomly divided into two groups. Patients in the control group were given IMRT after operation. Patients in the observation group were given TEM drug treatment on the basis of the control group after operation. Two groups of patients were treated for 6 cycles, followed up for 2 years, the 1-year survival rate, median time to recurrence and median survival time and adverse reactions in the course of treatment were analyzed at the end of treatment using SF-36 scale assessment of patients Quality of Life. Results The 1-year survival rate, median recurrence time and median survival time were 82.4% (28/34), (22 ± 4) months and (24 ± 4) months respectively in the observation group and 64.8% in the control group 22/34), (12 ± 4) months and (18 ± 4) months respectively. The observation group was significantly better than the control group, the difference was statistically significant (P <0.05); after the treatment, the observation group The total score of SF-36 in patients was significantly higher than that in control group (P <0.05). The bone marrow suppression, gastrointestinal reactions and incidence of abnormal liver function in both groups were significantly higher than those in control group , The difference was not statistically significant (P> 0.05). Conclusion IMRT combined with TEM treatment can significantly improve the survival rate and survival time of patients with residual lesion after BSG, and improve the quality of life of patients without increasing adverse reactions.