The Efficacy Analysis Of Postoperative Radioatherapy Combined With Temozolomide In High-grade Gliomas

Objective: The study focused on the clinical treatment effect of radiotherapy plustemozolomide in patients post glioma resection.Method: There are64cases with complete clinical data which collected from ourhospital from2008January to2013March, the pathological diagnosis were high-gradegliomas, including42anaplastic astrocytomas and22gioblastomas with46malepatients and16female patients. The patients were stratified into three groups accordingto different treatment methods, group A: blank control; group B: radiotherapygroup(RT); groupC: radiotherapy plus temozolomide (RT+TMZ).Radiotherapy: The radiological dose was2Gy, once a day with3D-CRT. Theradiotherapy was carried for five days per week with six weeks and the total dose was60Gy.TMZ:The dose of temozolomide was75mg/m2once a day, maintaining for42days while the radiotherapy was carried on; After the radiotherapy finished, the dose oftemozoline was150-200mg/m2once a day with2-6couses which consists four weeksand the temozolomide was only taken in the first five days per course.Imaging and clinical status analysis: The lesion changes of MRI and CT wasrecorded periodically, while the quality of life of patients was assessed with thecomparison between the status which was assessed periodically and statuspostoperation.Treatment analysis:1.The treatment analysis was assessed with the comparison oftwo methods, including the lesion changes of MRI and CT and the clinical statuscomparison.2.Comparing the survival rate and survival time of each groups withSPSS13.0software.Result:1. Adjuvant therapy in patients after2-3months later: the short-term effective rate of the group B(RT) and group C(RT+TMZ) was31%and54%(x2=1.44p>0.05)，respectively. The short-term treatment effect of group C was higher than group B, butthe result was not significant.2.The mean survival time was significantly longer in group C than group B(Group B:14.4months; Group C:18.1months,P <0.05) the median survival time wassignificantly longer in group C than group B (11.2months);group C:18.4months,P<0.05)3. The mean survival time and the median survival time were significantlylonger in patients of anaplastic astrocytomas(grade III)(17.0months and23.4months)than those of glioblastomas(grade IV)(14.3months and13.5months), and P<0.05.4. To compare the mean survival time and the median survival time of the totalremoval(20.5months,23.9months) and the subtotal removal of tumor(10.1months and9.7months), we found that the treatment effect of in patients with total removal wassignificantly better than those with subtotal removal(P <0.05).5. The group of KPS>80and the group of KPS<80whose mean survival time was18.9months and11.5months respectively as well as whose median survival time was23.5months and11.7months respectively, by statistical analysis, was foundsignificantly different(p<0.05).Conclusion:1.Different treatment methods have a big effect on the prognosis of patients whogot high grade gliomas.2.The comparison of radiotherapy plus TMZ and radiotherapy indicated thatRT+TMZ was much better on the improvement rate of clinical status for the early stagepatients with no significant difference on early imaging examinations.3.The survival time and rate was much better in group RT+TMZ with a betterPrognosis compared with group RT.4.The survival time and rate was much better in patients with Anaplasticastocytomas(grade III) than those with spongioblastomas (grade IV). The higher gradeof pa-thological diagnosis, the poorer prognosis.5.The survival time and rate was much better in patients with total removal thanthose with subtotal removal.6.The survival time and rate was much better in patients with a KPS>80than thosewith a KPS<80, the higher KPS, the better prognosis.