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目的评价三维适形放疗联合替莫唑胺治疗脑转移瘤的疗效及安全性。方法 60例脑转移瘤患者随机分为放化疗组和单纯放疗组,各30例。单纯放疗组给予全脑放疗40 Gy/20 f,局部缩野加量14~16 Gy/7~8 f。放化疗组在此基础上于放疗第1天开始口服替莫唑胺75 mg/m2,1次/d,共25 d。观察两组患者的有效率、中位生存期、神经系统症状缓解率及不良反应发生率。结果放化疗组与单纯放疗组有效率分别为86.7%、63.3%(P<0.05);中位生存期分别为12.0个月、9.1个月(P<0.05);神经系统症状缓解率分别为63.3%、53.3%(P>0.05);骨髓抑制发生率分别为16.7%、6.7%(P>0.05);胃肠道反应发生率分别为46.7%、33.3%(P>0.05)。结论三维适形放疗联合替莫唑胺治疗脑转移瘤,可提高疗效,不良反应小,值得临床推广。
Objective To evaluate the efficacy and safety of three-dimensional conformal radiotherapy combined with temozolomide in the treatment of brain metastases. Methods Sixty patients with brain metastases were randomly divided into radiotherapy and chemotherapy group and radiotherapy group, with 30 cases in each group. In the radiotherapy group, whole-brain radiotherapy was given to 40 Gy / 20 f, and local shrinkage was 14-16 Gy / 7-8 f. Radiotherapy and chemotherapy group on the basis of radiotherapy in the first day of oral temozolomide 75 mg / m2, 1 / d, a total of 25 d. Efficacy, median survival, neurological symptoms and incidence of adverse reactions in both groups were observed. Results The effective rates of radiotherapy and chemotherapy were 86.7% and 63.3% respectively (P <0.05). The median survival time was 12.0 months and 9.1 months (P <0.05). The rates of neurological symptoms relief were 63.3% (P> 0.05). The incidence of myelosuppression was 16.7% and 6.7% respectively (P> 0.05). The incidence of gastrointestinal reactions was 46.7% and 33.3% respectively (P> 0.05). Conclusion Three-dimensional conformal radiotherapy combined with temozolomide in the treatment of brain metastases can improve the curative effect and adverse reactions, which is worthy of clinical promotion.