论文部分内容阅读
目的:评价替莫唑胺联合全脑放疗治疗脑转移瘤患者的疗效及安全性。方法:将55例脑转移瘤患者(转移灶>3个)随机分为替莫唑胺联合放疗组及放疗组。替莫唑胺联合放疗组予以常规分割行全脑放疗,DT:40 Gy(2 Gy.d-1,每周5 d),于放疗d1开始给予替莫唑胺口服治疗(75 mg.m-2.d-1),放疗结束后每28 d予以替莫唑胺口服5 d(200 mg.m-2.d-1)化疗,共6周期。放疗组全脑放疗,DT:40 Gy(2 Gy.d-1,每周5 d)。使用Kaplan-Meier方法计算生存率、无进展生存率及生存曲线,组间生存率比较应用Log-rank检验。结果:替莫唑胺联合放疗组与放疗组的客观缓解率分别为76.9%和48.0%(P=0.033);中位生存期分别为8.0和5.5个月,差异达统计学显著性(P=0.025);中位无进展生存期为分别为5.0和3.1个月,差异达统计学显著性(P=0.020)。替莫唑胺联合放疗组发生恶心、呕吐的患者显著高于单纯放疗组,但大部分患者可耐受。结论:替莫唑胺联合全脑放疗有可能提高脑转移瘤患者的局部控制及远期生存,且耐受性良好。
Objective: To evaluate the efficacy and safety of temozolomide combined with whole brain radiotherapy in patients with brain metastases. Methods: 55 patients with brain metastases (metastasis> 3) were randomly divided into temozolomide combined radiotherapy group and radiotherapy group. Temozolomide combined with radiotherapy group was given routinely divided whole-brain radiotherapy, DT: 40 Gy (2 Gy.d-1, 5 d per week). Temozolomide was given orally (75 mg.m-2.d-1) After chemotherapy, temozolomide was administered orally for 5 days (200 mg.m-2.d-1) every 28 days for 6 cycles. Radiotherapy group whole brain radiotherapy, DT: 40 Gy (2 Gy.d-1, 5 d per week). Survival, progression-free survival and survival curves were calculated using the Kaplan-Meier method. Log-rank tests were used to compare survival rates between groups. Results: The objective response rates of temozolomide combined with radiotherapy and radiotherapy were 76.9% and 48.0%, respectively (P = 0.033). The median survival time was 8.0 and 5.5 months respectively. The difference was statistically significant (P = 0.025). The median progression-free survival was 5.0 and 3.1 months, respectively, with a statistically significant difference (P = 0.020). Temozolomide combined with radiotherapy group nausea, vomiting was significantly higher than the radiotherapy alone group, but most patients can tolerate. Conclusion: Temozolomide combined with whole brain radiotherapy may improve the local control and long-term survival of patients with brain metastases and is well tolerated.