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目的观察顺铂联合替莫唑胺同期放化疗方案治疗MGMT启动子无甲基化高分级胶质瘤的近期疗效。方法 11例患者入组,均于手术治疗后行替莫唑胺同期放化疗,放疗阶段每天口服替莫唑胺,75 mg/m2;每周一次顺铂25mg/m2,静脉滴注,即第1、8、15、22、29、36天。放疗结束后4周,予替莫唑胺联合顺铂辅助化疗,每疗程予顺铂25 mg/m2,静脉滴注,第1、2、3天;每天替莫唑胺200 mg/m2,口服,第2~6天。每28 d重复该方案,共6个疗程。结果 11例患者均完成治疗。疗效评价:部分缓解(PR)2例,稳定(SD)9例;6个月疾病无进展率(PFR)72.7%。至末次随访(时间为2015年2月,中位随访期为9个月),5例进展,1例死亡。不良反应程度多为Ⅰ~Ⅱ级,无Ⅲ级以上反应。结论顺铂联合替莫唑胺同期放化疗方案治疗MGMT启动子无甲基化高分级胶质瘤患者不良反应小,近期疗效较好,远期疗效需进一步研究。
Objective To observe the short-term curative effect of cisplatin combined with temozolomide concurrent chemoradiotherapy regimen on MGMT promoter without methylated high-grade glioma. Methods Eleven patients were enrolled and received temozolomide concurrent chemoradiotherapy after surgery. Temozolomide was given daily at 75 mg / m2 in the radiotherapy stage. Once weekly, cisplatin (25 mg / m2) 22,29,36 days. Four weeks after the end of radiotherapy, temozolomide combined with cisplatin adjuvant chemotherapy was given to each patient with cisplatin 25 mg / m2 intravenously for 1, 2 and 3 days; temozolomide 200 mg / m2 orally daily for 2 to 6 days . The program was repeated every 28 days for a total of 6 courses. Results All the 11 patients completed the treatment. Efficacy evaluation: partial response (PR) in 2 cases, stable (SD) in 9 cases; 6 months disease progression-free rate (PFR) 72.7%. To the last follow-up (in February 2015, the median follow-up period was 9 months), 5 patients progressed and 1 patient died. Adverse reactions were mostly grade Ⅰ ~ Ⅱ, no grade Ⅲ above reaction. Conclusions The cisplatin combined with temozolomide concurrent chemoradiotherapy regimen in patients with MGMT promoter without methylated high-grade glioma has a small adverse reaction and good curative effect in the near future. The long-term curative effect needs further study.