摘要
目的探究肿瘤切除术联合卡莫司汀缓释植入剂治疗高级别脑胶质瘤的临床疗效。方法选取2012年1月至2014年1月本院收治的60例经MRI和冷冻病理初步诊断为高级别恶性脑胶质瘤的患者,按照2:1分配病例数及分层随机方法将患者分为试验组(40例)、对照组(20例),所有患者均给予显微手术治疗,肿瘤切除后,试验组瘤腔内置入卡莫司汀缓释植入剂,对照组瘤腔内置入安慰剂。比较两组患者的总生存期(OS)及12个月生存率,并进行生活质量评价及安全性分析。结果试验组OS生存曲线和PFS生存曲线均优于对照组,比较差异有统计学意义(P<0.05);与术前相比,两组患者术后1w、术后1个月、术后3个月、术后6个月的KPS评分、QOL评分均升高,随时间进展呈先升高后降低的趋势,以术后1个月最高,手术前后不同时间点比较差异有统计学意义(P<0.05);试验组术后不同时间点的KPS评分、QOL评分均高于对照组术后相应时间点(P<0.05);在12个月生存率方面,试验组高于对照组,比较差异有统计学意义(χ~2=4.66,P<0.05);在不良反应总发生率方面,试验组较对照组无明显增加,(χ~2=0.33,P>0.05)。结论肿瘤切除术联合卡莫司汀缓释植入剂治疗高级别脑胶质瘤患者的临床效果显著,值得在临床上推广应用。
Objective To investigate the clinical value of tumor resection combined with carmustine sustained-release implants in the treatment of high-grade malignant gliomas.Method Sixty patients with highgrade malignant glioma diagnosed by MRI and frozen pathology were enrolled in our hospital from January patients were treated with microsurgery.After tumor resection,the patients in the experimental group were implanted with carmustine slow-release suppositories in the experimental group(forty cases)and the control group(twenty cases)Into the agent,the control group were placed in the tumor cavity placebo.The overall survival(OS)and12-month survival rates of the two groups were compared,and the quality of life assessment and safety analysis were performed.Results The OS survival curve and PFS survival curve of the experimental group were better than those of the control group,the difference was statistically significant(P<0.05).Compared with preoperative,the KPS score and QOL score of the two groups were increased at1week,1month,3months and6months after operation,and increased with time and then decreased,the difference was statistically significant(P<0.05).The KPS score and QOL score of the experimental group at different time points were higher than those of the control group at the same time point the difference was statistically significant(P<0.05);In the twelve months survival rate,the test group was higher than the control group,the difference was statistically significant(χ2=4.66,P<0.05);In the total incidence of adverse reactions,the experimental group than the control group was no significant increase,the difference was not statistically significant(χ2=0.33,P>0.05).Conclusion Tumor resection combined with slow release of carmustine in the treatment of high-grade malignant gliomas patients with clinical results is significant and worthy of clinical application.
作者
刘岱
吉华平
LIU Dai;JI Hua-ping(Department of Neurosurgery,the Huaian First People's Hospital, Jiangsu 223300, China)
出处
《脑与神经疾病杂志》
2017年第7期429-433,共5页
Journal of Brain and Nervous Diseases
