Clinical effect of temozolomid combined with concurrent radiotherapy on high grade intracranial glioma / 肿瘤研究与临床

ABSTRACT

Objective To evaluate the survival and adverse effects of adjuvant concurrent temozolomid (TMZ) combined with radiochemotherapy in postoperative patients with high grade intracranial glioma.Methods 84 postoperative patients with high grade intracranial glioma were randomly divided into the observation group (42 cases including 25 grade Ⅲ cases and 17 grade Ⅳ cases) and the control group (42 cases including 23 grade Ⅲ cases and 19 grade Ⅳ cases).All patients were treated with concurrent radiochemotherapy after surgical operations,the total radiation dose was 60-66 Gy.The patients in observation group were given daily oral TMZ 75 mg/m2 during radiotherapy.4 weeks after radiotherapy,all of the patients received 6 cycles of TMZ,each cycle lasted 5 days with 28 days interval between each cycles.150 mg/m2 of TMZ was given for the first cycle for 5 days,followed by 200 mg/m2 of drug for the rest of the cycles if no significant drug related toxicities were observed.Results The overall response rates (CR+ PR) were 71.7 ％ (33/46) in the observation group,and 32.6 ％ (15/46) in the control group,and with significant difference between the two groups (P ＜ 0.001).The 1,2 and 3 year survival rates of patients in the observation group were 71.7 ％,47.8 ％,36.9 ％,and 56.5 ％,26.1％,15.2 ％ in the control group.The significant differences were found in 2-year and 3-year survival rates between the two groups (P =0.031,0.018).The median recurrent period in the observation group were 22 and 12 months in the control group,and with singnificant difference (P =0.015).The main side effects were limited to grade Ⅰ or Ⅱ.Conclusions Concurrent TMZ combined with radiotherapy in the treatment of high grade gliomas has better clinical efficacy,and can improve the 2-year and 3-year survival rates.Patients tolerate the strategy well and no severe toxicities are observed.