三维适形放疗联合恩度及尼莫司汀治疗高分级脑胶质瘤临床研究(1)
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【摘要】 目的 研究高分级脑胶质瘤术后三维适行放疗联合恩度及尼莫司汀的有效性和安全性。方法 选择我院收治的15例高分级脑胶质瘤术后患者行三维适行放疗,DT 50 gy 68Gy;同时静脉给予恩度15 mg/d,连用14 d;尼莫司汀90 mg/m2,第1天给药;28 d为1周期。以RECIST标准评价疗效,以NCI标准评价毒性反应。结果 15例患者均可评价客观疗效及毒副反应。CR 53.3%,PR 26.7%,SD 13.3%,PD 6.7%,RR(CR+PR)80.0%,DCR(CR+PR+SD)为93.3%。中位无进展生存时间14个月,1年和2年生存率分别为86.7%和60.0%。结论 三维适行放疗联合联合恩度及尼莫司汀治疗高分级脑胶质瘤安全、有效。
【关键词】 三维适形放疗;恩度;尼莫司汀;高分级脑胶质瘤
Clinical Study of three dimensional conformal radiotherapy plus endostar and nimustine in treatment of postoperative high grade cerebral glioma
MA Xu hui,MIAO Zhen jing,DAI Xin guo,et al.
Department of oncology,No.159 hospital of PLA,Zhumadian,Henan 463008,China
【Abstract】 Objective To observe the clinical benefit and safety of three dimensional conformal radiotherapy(3 DCRT) combined with Endostar and Nimustine(ACNU) in patients with postoperative high grade cerebral glioma.Methods Fifteen postoperative patients with pathologically confirmed high grade m alignant glioma were treated by 3 DCRT with a dose of 50~68 Gy,and combined with Endostar and ACNU.The efficacy was evaluated by RECIST standard and toxicity was evaluated by NCI standard.Results The overall response rates were 80.0%,including 8(53.3%) patients with complete responses,4(26.7%) patients with par responses,2(13.3%) patients with stable disease.One and two years suvivals were 86.7% and 60.0%,respectively.Conclusion 3 DCRT combined with Endostar and Nimustine is effective,good tolerance and safety in the treatment of postoperative high grade cerebral Glioma.
【Key words】 Three dimensional conformal radiotherapy; Endostar; Nimustine,High grade cerebral Glioma
脑胶质瘤约占颅内肿瘤的40%~50%,绝大多数恶性程度高,侵袭性强,手术不易全切,极易复发,传统辅助放化疗虽能在一定程度上改善预后,但总体疗效仍不理想。2006年8月至2008年3月,采用三维适形放疗(3 DCRT)和联合恩度及尼莫司汀治疗术后高分级脑胶质瘤患者15例,并评价其疗效和安全性。
1 对象与方法
1.1 对象 曾行手术治疗的高分级脑胶质患者15例中,初治12例,复治3例;年龄19～69岁,中位年龄42岁;男8例,女7例;部位:颞叶7例,额叶4例,顶枕叶4例。病理分类(WHO2000年):间变性星形细胞瘤(Ⅲ级)9例,多形性胶质母细胞瘤(Ⅳ级)6例。均符合以下入组条件:明确的病理诊断;有术后残留或复发的影像学(CT/MRI)证据且可评价病灶;3个月内未行放化疗;预计生存期3个月以上;无心、肝、肾等重要脏器功能障碍;非过敏体质;均签署知情同意书,依从性良好;血HGB≥100 g/L,ANC≥2.0×109/L,PLT≥100×109/L;Cr≤1.0×正常上限(NM),AST、ALT≤2 ......
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