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1、大分割放療聯(lián)合替莫哇胺治療大體積腦轉(zhuǎn)移瘤的效果觀察劉軍華湖北省棗陽市第一人民醫(yī)院摘要:A的觀察大分割放療聯(lián)合替莫唑胺治療大體積腦轉(zhuǎn)移瘤的臨床療效。方法選取90例大體積腦轉(zhuǎn)移瘤患者為研宄對象,隨機(jī)將患者分為對照組和實驗組,每組45例。對照組患者給予大分割放療治療,實驗組患者在大分割放療的基礎(chǔ)上每日加服1次替莫唑胺150mg/m2,連續(xù)口服28天即1個放療周期結(jié)束后,每個放療周期的前5天給予每天1次UI服替莫唑胺200mg/m2輔助治療。治療6個療程后觀察2組的臨床療效及不良反應(yīng),并分析患者1年隨訪記錄。結(jié)果實驗組患者的臨床治
2、療有效率為75.56%,明顯高于對照組的48.89%(P<0.05)。實驗組患者半年及1年生存率高于對照組,復(fù)發(fā)率低于對照組(P<0.05)。2組患者均有放射性腦水腫、放射性腦壞死、腦神經(jīng)損傷、惡心嘔吐及發(fā)熱等不良反應(yīng),實驗組患者臨床還表現(xiàn)出骨髓抑制及貧血等不良反應(yīng),但均可耐受。結(jié)論大分割放療聯(lián)合替莫唑胺對臨床治療大體積腦轉(zhuǎn)移瘤安全有效,患者臨床癥狀可得到明顯改善,臨床不良反應(yīng)較輕,值得推廣應(yīng)用。關(guān)鍵詞:大分割放療;替莫唑胺;大體積腦轉(zhuǎn)移瘤;臨床療效;收稿日期:2016—10-10ObservationoftheEffec
3、tofLargeFractionatedRadiotherapyCombinedwithTemozolomideforLargeVolumeBrainMetastasesLIUJunhuaTheFirstPeople’sHospitalofZaoyang:Abstract:ObjectiveTostudytheclinicaleffectoflargefractionatedradiotherapycombinedwithtemozolomideforlargevolumebrainmetastases.Methods90
4、casesoflargevolumeinpatientswithbrainmetastasesastheobjectofstudy,thepatientswererandomlydividedintothecontrolgroupandtheexperimentalgroup,eachgroupwith45cases.Thecontrolgroupweretreatedwithhypofractionatedradiationtherapy,theexperimentalgrouponthebasisofthecontro
5、lgroupreceivedhypofractionatedradiotherapyplusdailyoralatemozolomide150mg/m2,orallyfor28dayswasacycleofradiotherapyafter.After5daysbeforeeachtreatmentcyclegiveneachandeverydayorallytemozolomide200mg/m2,after6coursesoftreatmentobservationclinicalefficacyandadverser
6、eactionsofthe2groups,andanalysisofthepatientayearfollow-uprecords.ResultsAdversereactionsintheexperimentalgroup,theclinicaleffectiveratewas75.56%,whichwassignificantlyhigherthanthatcontrolgroup48.89%(P<0.05).Thepatientsintheexperimentalgroupfor6monthsand1-yearsurv
7、ivalratewashigherthanthatofthecontrolgroup,therecurrenceratewaslowerthanthatofthecontrolgroup(P<0.05).The2groupsofpatientshadradioactivecerebraledema,radiationnecrosisofthebrain,braindamage,nausea,vomiting,andfever.Intheexperimentalgroup,thepatientsalsoshowedbonem
8、arrowsuppressionandanemia,anclotheradversereactions.ConclusionLargefractionatedradiotherapycombinedwithtemozolomideforlargevolumeofbrainmetastasesissafe