| Objective: The effect and safety of radiotherapy accompanying with perioral temozolomide as chemotherapy for high-risk adult with low-grade gliomas after operation are assessed through summarizing the total rate of survivors and progression-free survivors in three years to analyze the application of this project, which also provide information for the clinical research of high-risk low-grade glimos patients.Methods: 22 high-risk patients with low-grade glioms after surgery in affiliated hospital between Jan, 2009 to Feb., 2012 were observed in our works, who were randomly and equally assigned to the radiotherapy with chemotherapy group(observation group) or only radiotherapy group(compared group). For observation group, the standard 6-10 MV X-ray irradiation and linear accelerator radiation therapy(1.8 Gy per day and 5 days per week, total six week with 54Gy). The tumor is assessed by the international standard through MRI or CT after 72 h and per 3-6 months. At the same time, the radiotherapy was applied by using perioral temozolomide 75mg/m2 per day within six weeks and using 150-200 mg/m2 per day in first five days, which was recycled with five courses of treatment. The 3 years OS, PFS and toxicity and so on for patients were detected in the next 3 years. The blood routine, blood biochemistry and toxicity were detected per week and assessed by international standard. The SPSS19.0statistics software with t inspect, X2 inspect, Kaplan-Meier analysis method were used to analyze the data. If P is less than 0.05, it has statistics meaning..Results:1.The total survival rate of observed group is 72.7% in 3 years, while that of the compared group is 63.6%. Therefore, P is larger than 0.05, which means no statistic meanings. And the progression-free rate of observed group is 63.6% VS. 45.5% for compared group, the p value is smaller than 0.05, which means there are statistic meanings.2.Monitoring concurrent chemoradiotherapy plus adjuvant chemotherapy for stage,toxicity(45.4% vs36.3%), postoperative radiotherapy while giving temozolomide chemotherapy plus adjuvant chemotherapy did not significantly increase the incidence of adverse reactions(P> 0.05).3.Observation group of 40 patients over the age of 3-year OS was 66.7%, and3-year PFS was 50%. Preoperative KPS KPS score greater than 70 and less than 70 comparative observation group 3-year overall survival(80% vs66.7%), 3-year progression-free survival(80% vs50%). Contrast incomplete cut full cut 3-year overall survival(100% vs57%) and 3-year progression-free survival(75% vs57%).4.Univariate and multivariate analysis indicated that age, preoperative KPS, extent of tumor resection, and comprehensive treatment method is combined with chemotherapy in patients with high-risk LGG affect adult 3-year and 3-year survival rate was an important factor in progression-free survival(P <0.05), gender, and other factors is associated with epilepsy multivariate COX regression analysis showed that patients with high-risk adults LGG prognostic analyzes were not statistically significant(P> 0.05).Conclusion: 1. For high-risk adult patients with low-grade gliomas after radiation therapy and combined with temozolomide chemotherapy in high-risk one standardized LGG treatment of adult alternative approach, but there are many aspects worthy of improvement, but require a large sample, for a long time to verify.2. After a standardized treatment, although not significantly improve high-risk adult patients with LGG 3-year overall survival rates, but can significantly improve the3-year progression-free survival.3. For high-risk adults LGG after temozolomide chemotherapy plus concurrent radiotherapy and adjuvant chemotherapy did not significantly increase the incidence of adverse reactions.4. For high-risk adult patients with LGG, age, KPS score, extent of surgery,whether surgery combined with radiotherapy, radiotherapy and chemotherapy are effective indicators to determine the prognosis of patients. |
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