Curative Efficacy Evaluation Of Radiotherapy Combined With Tmz Chemotherapy Of Malignant Glioma After Operation

Objective:To observe the curative efficacy of three-dimensional conformal radiotherapy (3D-CRT) combined with temozolomide (TMZ) treatment for malignant glioma after surgery by retrospective analysis. The survival rate, survival time and other related information were collected after different treatments, the knowledgement of advantages and disadvantages of different treatments via prognosis analysis will contribute to help physicians choose the optimal treatment strategy, prolong survival and improve quality of life of glioma patients.Materials and methods:①Case Source: 102 cases during 2007-2009 from certain Rank III hospital were chosen according to post-operative pathological diagnosis ofⅢ,Ⅳgrade high-grade malignant glioma patients, 60 males and 42 females were included. All the cases were divided into two groups, radiotherapy combined with temozolomide concurrent chemotherapy (A group) and radiotherapy only(B groups).②Treatment strategy and medication: A group received three-dimensional conformal radiotherapy and temozolomide simultaneously, 60Gy total dose of radiotherapy (2Gy/ day, five days a week for 6 weeks) was introduced within one month of post-operation by using VARIAN-21EX linear accelerator 6-10MV-X line and three-dimensional treatment planning system. Fixed head with plastic head mold, enhanced CT scan, slice thickness 3mm, the incoming image data planning system, designed 3-5 coplanar or non coplanar field, 95% isodose curve, including PTV, reset validated the implementation of treatment . Temozolomide chemotherapy: 75mg/m~2 / day, orally intake for 6 weeks. Radiotherapy after sequential chemotherapy ,150-200 mg/m~2, days 1-5, repeated every 28 days, once every 6 cycles. B group was treated only by a simple three-dimensional conformal radiotherapy. A group approach with radiotherapy.③Efficacy assessment: The survival rate, disease-free survival time were collected and compared using appropriate statistical methods.④Statistical analysis: SPSS 12.0 statistical software was used to analyze data, t test and x2 analysis were used in this study for comparison, Keplan-Meier survival analysis and Cox regression analysis were also adopted.Results:The single- factor analysis illustrated that different treatments shown influence on survival rate, survival time and disease-free survival time. Use of modern three-dimensional conformal radiotherapy (3D-CRT) combined with temozolomide (TMZ) chemotherapy for treatment of patients with an average tumor-free survival time and median survival time was 14.2396 and 18.0000. The use of radiotherapy alone in patients with an average tumor-free survival time and median survival time was 10.7245 month and 9.7000 months. Use of modern three-dimensional conformal radiotherapy (3D-CRT) combined with temozolomide (TMZ) chemotherapy for treatment of patients with an average survival time and median survival time was 17.1377 and 19.3000 . The use of radiotherapy alone in patients with an average survival time and median survival time was 13.7469 and 11.3000. This shows that the use of modern three-dimensional conformal radiotherapy (3D-CRT) combined with temozolomide (TMZ) chemotherapy for treatment group, patients with an average tumor-free survival and median survival time, the average survival time and median survival time compared with radiotherapy alone group were significantly prolonged. Multivariate analysis showed that treatment, age, treatment intensity, KPS scores in patients with malignant glioma tumor-free survival of the main factors.Conclusion:Three-dimensional conformal radiotherapy (3D-CRT) combined with temozolomide (TMZ) chemotherapy has advantage over 3D-CRT only treatment for malignant glioma patients after surgery. The survival rate was improved, survival time and disease-free survival time were extended, suggesting this combination treatment can be used in clinical practice. Under this condition age, surgical treatment of microscopic total resection and KPS scores more than seventy are protective factors for the prognosis. The patient's gender, histological grade are not independent factors for malignant glioma prognosis.