Retrospective Study Of The Curative Effect Of Temozolomide For Different Molecular Pathologic Types Anaplastic Astrocytoma And Glioblastoma

Objective:To retrospectively study the curative effect of Temozolomide between different molecular types Anaplastic Astrocvtoma and Glioblastoma.Methods:A total of 68 patients with complete clinical data,including 38 males and 30 females,were accepted in this trial.These patients visited the Second Affiliated Hospital of Dalian Medical University from January 2014 to January 2018.According to different treatment methods divided into pure line postoperative radiotherapy treatment group(RT),and others treated with postoperative radiotherapy and Temozomide auxiliary-treatment were divided into combined treatment group(TMZ).The TMZ was subset to grroup TMZ A1,group TMZ A2,group TMZ A3,group TMZ B1,group TMZ B2 and TMZ B3 group.Treatment methods:all patients were intensity modulated radiation therapy 4 weeks after surgery or Temozolomide.After 3 months,all patients were took brain CT or MR]scan and periodic review to find whether tumor recurrence.Results:In this study.3 months after the completion of adjuvant treatment,the patients in the RT group and TMZ group were reviewed for the results of craniocerebral plain scan plus enhanced MRI.as well as the symptoms and signs,and the treatment efficiency and disease control in the TMZ group were better than those in the RT group.The treatment efficiency and disease control of TMZ A1 group were better than that of TMZ A2 group.The treatment efficiency of TMZ A1 group was better than that of TMZ A3 group,but it was not comparable in terms of disease control rate.There was no significant difference in the treatment efficiency and disease control between TMZ A2 group and TMZ A3 group.The treatment efficiency and disease control of TMZ B1 group were stronger than that of TMZ B2 and TMZ B3 group.There was no significant difference in the treatment efficiency and disease control between TMZ B2 group and TMZ B3 group.In terms of progression-free survival time and total survival time,TMZ A1 group was longer than TMZ A2 and TMZ A3 groups,and there was little difference between TMZ A2 and TMZ A3.In terms of progression-free survival time.TMZ B1 group was longer than TMZ B2 and TMZ B3 group,and there was no significant difference between TMZ B2 and TMZ B3.In terms of total survival,there was little difference between the three.Conclusion:1.Between the Anaplastic Astrocytoma and Glioblastoma with different molecular types.postoperative radiotherapy combined with Temozolomide adjuvant therapy is significantly better than radiotherapy alone,and the former has a more significant therapeutic efficiency and disease control rate.2.Among The different molecular classifications of Glioblastoma and Anaplastic Astrocvtoma,patients with IDH mutation type are found having better effect and disease control rates than the wild type or the undifferentiated,but the IDH wild type and the undifferentiated effect and disease control rates have no obvious difference.The group number is less,so the conclusion is no perfect and need more high-quality randomized cases to improve.3.In the different molecular classification of Glioblastoma,patients with IDH mutation type of progression-free survival and overall survival time is longer than the wild type or undifferentiated.Between different molecular classifications of Anaplastic Astrocytoma_the IDH mutation type progression-free survival time of patients is longer than the wild type or the undifferentiated type,but the total survival time can not be compared.It may be these patients have a long survival time,but the experiment failed to continue follow-up for this series of patients.In a word,this retrospective study suggests that we use Temozolomide adjuvant therapy for IDH mutant type tumor may have better clinical individual therapy effect.can improve the survival and prognosis of patients.For it is a small sample retrospective study and follow-up time is short,the further research is needed to confirm the above.