| Objective: Glioma is the most common human brain tumor, accounting for about 35.26%-60.96% of all brain tumors in our country. In the clinical work, usually, glioma which belongs to gradeⅢandⅣis called malignant glioma. It contains anaplasia astrocytoma and glioblastoma. The most popular opinion of treating malignant glioma focus on operation and postoperation radiotherapy. With the investigation of this disease, chemotherapy comes to be one of the most important means to fight against malignant glioma.Now, there are various chemotherapy drugs for patients, but, the effections are different among them. Temozolomide (TMZ) is a new alkylating agen for curing malignant glioma.It is for oral use, and can be absorbed completely. It can pass blood brain barrier with easy. Thus, it becomes one of the most efficient chemotherapy drugs to fight against malignant glioma. But, for most chemotherapy drugs, their therapeutic effections can not satisfy us because of drug resistance of tumors. O6-methylguanine-DNA methyltransferase (MGMT) is one agent for drug resistance of nitrosourea.Our purpose of this investigation is evaluating the effection of TMZ in the malignant glioma, and discussing the relationship between MGMT and the drug resistance of TMZ by detecting MGMT in the tumor tissue.Method: Patients whose pathological records are glioma gradeⅢandⅣfrom the Second Hospital, Hebei Medical University in the period of Feb, 2006 to Jun, 2007 were included in this study. They are selected with random and should fit the indication of TMZ. There are 36 patients in the study, including 24 male and 12 female, Anaplatic astrocytoma 22cases, Anaplatic oligodendroglioma 2 cases, glioblastoma 12 cases. After surgery and radiotherapy, they take TMZ according to their body surface area. Then they should regularly recheck CT or MRI; They should recheck chemical examination and should receive clinical follow-up visit. We detect MGMT by immunohistochemistry from their patho-paraffin embedded tissue blocks.Result:1 The effection of chemotherapy:by compareing the imageology, there are 3 cases of complete remission in all the 36, 10 cases of partial remission, 4 cases of improvement,10 cases of stabilization, and 8 cases of progression including 2cases of death.And 1 case lost. Effective power is 37.14%. Disease control rate is 77.14%; survival rate with no-progression of 6 months is 45.71%.2 Adverse reaction: the main adverse reaction of TMZ are nausea and emesis. Almost 51.43% of patient experienced this bad effect. Bone marrow depression and functional lesion of liver and renal function are the second, and they are retroconvertibal.3 Chemotherapy scheme and the resul of MGMT: 35 patients altogether received 213 periods of TMZ, at the averge of 6.1 periods. They did not receive other chemotherapy. there are 17 Patients of positive MGMT (++,+) , 18 negative (士,-) . None patient exit this study for the adverse effect of TMZ.4 The relationship between MGMT and clinical effect: the positive rate (++,+) of MGMT in all the 35 patients is 48.57%(17/35), 15.38% (2/13) in objective utility group (CR+PR), 68.18% (15/22) in ineffective group (MD+SD+PD). There is statistical significance (P<0.05) between different clinical effect groups for MGMT.Conclution:1 The effective power and control rate are satisfacting and the the main adverse reaction of TMZ are nausea and emesis. Bone marrow depression is retroconvertibal.2 The expression of positive MGMT(++,+) in ineffective group(MD+SD+PD)is higher than in the utility group(CR+PR), which hints that MGMT is one of the drug resistant factor in the treatment of malignant glioma by TMZ.
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