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恶性胶质瘤术后同步放化疗

[Combined postoperative radiotherapy and chemotherapy for malignant gliomas].

作者信息

Aida T, Sugimoto S, Tokuda K, Abe H, Ikoda T, Itoh T, Ueno K, Kashiwaba T, Kaneko S, Kawamoto T

机构信息

Department of Neurosurgery, Hokkaido University School of Medicine.

出版信息

Nihon Gan Chiryo Gakkai Shi. 1990 May 20;25(5):952-9.

PMID:2167916
Abstract

A retrospective analysis was performed on 70 patients with malignant supratentrial astrocytic gliomas (astrocytoma Grade III or glioblastoma multiforme) treated with radiotherapy combined with vincristine (VCR), ACNU and PS-K. From January 1979 through December 1983, 27 patients were treated with treatment protocol A (group A). Protocol A was as follows: (1) total dose of 50 to 65 Gy radiation was given after surgery; (2) radiation plus combination VCR (0.02 mg/kg IV on 1st and 29th day of radiation) and ACNU (2 mg/kg IV 24 hrs after VCR) (3) after synchronized radiotherapy, ACNU (2 mg/kg IV every 6 or 8 weeks) and PS-K (3 or 6 g PO every day). Other 43 patients were treated with treatment protocol B (group B) from January 1984 through June 1988. Protocol B was as follows: (1) radiation dose was same as protocol A; (2) radiation plus combination VCR (0.02 mg/kg IV one day before radiotherapy) and ACNU (2 mg/kg IV on 1st and 1 mg/kg IV on 7, 21, 35th day, 1 hour before radiotherapy) (3) maintenance chemotherapy was same as protocol A. The difference between protocol A and protocol B was based on treatment schedule of ACNU. The characteristics of all patients were studied and identified, mainly age, histologic type, initial performance status, extent of tumor resection, maintenance chemotherapy. The reduction rate of tumor volume was 46.7% in the A group and 49.9% in the B group (not significant). The survival rates at 1, 2 and 3 years after surgery were 74.1%, 55.6% and 51.9% respectively for A group, and 80.5%, 42.4%, and 42.4%, respectively for B group.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对70例幕上恶性星形细胞瘤(III级星形细胞瘤或多形性胶质母细胞瘤)患者进行回顾性分析,这些患者接受了放疗联合长春新碱(VCR)、嘧啶亚硝脲(ACNU)和云芝多糖-K(PS-K)治疗。1979年1月至1983年12月,27例患者采用治疗方案A(A组)进行治疗。方案A如下:(1)术后给予50至65 Gy的总辐射剂量;(2)放疗联合VCR(放疗第1天和第29天静脉注射0.02 mg/kg)和ACNU(VCR注射24小时后静脉注射2 mg/kg);(3)同步放疗后,每6或8周静脉注射ACNU(2 mg/kg)和每天口服PS-K(3或6 g)。1984年1月至1988年6月,其他43例患者采用治疗方案B(B组)进行治疗。方案B如下:(1)辐射剂量与方案A相同;(2)放疗联合VCR(放疗前1天静脉注射0.02 mg/kg)和ACNU(放疗第1天静脉注射2 mg/kg,放疗前1小时在第7、21、35天静脉注射1 mg/kg);(3)维持化疗与方案A相同。方案A和方案B的区别在于ACNU的治疗方案。研究并确定了所有患者的特征,主要包括年龄、组织学类型、初始功能状态、肿瘤切除范围、维持化疗情况。A组肿瘤体积缩小率为46.7%;B组为49.9%(无显著差异)。A组术后1年、2年和3年生存率分别为74.1%、55.6%和51.9%;B组分别为80.5%、42.4%和42.4%。(摘要截取自250字)

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