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目的探讨高级别胶质瘤患者放射、化学治疗后假性进展的临床特点、诊断与处理。方法分析2008年6月2009年6月接受综合治疗的31例高级别胶质瘤患者临床资料,对假性进展的患者进行回顾分析,按照实体瘤疗效评判标准应用磁共振进行疗效评价。结果 31例术后病理诊断为高级别胶质瘤的患者,替莫唑胺(TMZ)同期放射、化学治疗后维持TMZ辅助化学疗法,放射治疗后早期发生假性进展4例(14%)。结论对于TMZ同期放射、化学治疗后早期出现的影像学疑似进展,不要急于下结论,了解假性进展的临床特点,结合功能影像学检查可能会有助于临床医生的判断与处理。
Objective To investigate the clinical features, diagnosis and treatment of pseudo-progression after radiotherapy and chemotherapy in patients with high-grade gliomas. Methods The clinical data of 31 patients with high grade gliomas undergoing comprehensive treatment in June 2008 and June 2009 were analyzed. The patients with false progress were retrospectively analyzed. The therapeutic effect was evaluated according to the evaluation criteria of solid tumor efficacy. Results Twenty-one patients with high-grade gliomas who were pathologically diagnosed postoperatively received temozolomide (TMZ) concurrently. Chemotherapy was followed by TMZ adjuvant chemotherapy. Four patients (14%) experienced false advancement after radiotherapy. Conclusions For the suspected radiological and radiological researches of TMZ in the early stage of TMZ, do not rush to conclusions. To understand the clinical features of the false advances, combined with functional imaging may be helpful for clinicians to judge and deal with them.