临床神经外科杂志2024，Vol.21Issue(4)：402-406,5.DOI:10.3969/j.issn.1672-7770.2024.04.008
术后复发性脑胶质瘤治疗新策略——脉冲式低剂量率再程放疗
A new strategy for the treatment of postoperative recurrent glioma:pulse low-dose rate re-radiotherapy
摘要
Abstract
Objective To evaluate the efficacy of pulse low-dose rate(PLDR)combined with bevacizumab and temozolomide in the treatment of recurrent glioblastoma.Methods Fifty-one patients with recurrent glioma after postoperative radiotherapy admitted to the Department of Tumor Radiotherapy,First Affiliated Hospital of University of Science and Technology of China from March 2020 to December 2022 were analyzed retrospectively,including 24 patients in the experimental group treated with PLDR combined with bevacizumab and temozolomide,and 27 patients in the control group treated with bevacizumab and temozolomide.PLDR radiotherapy regimen consisted of a prescription dose of DT 50-54 Gy,2 Gy/dose,divided into 10 pulse radiation,with the pulse interval time of 3 minutes,a dose rate of 0.067 Gy/min,and a single treatment duration of 30 minutes.Peripheral blood CD4+and CD8+T lymphocyte levels were measured before and after radiotherapy.One month after radiotherapy,head magnetic resonance imaging(MRI)was performed to evaluate the regression of recurrent lesions,and patients were evaluated every 3 months thereafter.Results Compared with the chemotherapy group alone,progression free survival(PFS)was significantly improved by PLDR+temozolomide(7.9 months vs 5.9 months,P<0.05).The combined regimen did not significantly increase the incidence of side effects of secondary radiation.The proportion of CD4+T cells(42.62%vs 33.31%,P<0.05)and CD8+T cells(38.53%vs 26.25%,P<0.05)in the peripheral blood of patients in the experimental group was significantly increased.Conclusions The application of PLDR combined with temozolomide in patients of recurrent glioma post-surgery and radiotherapy can improve therapeutic efficacy and activate the immune response of patients.关键词
复发/胶质瘤/再程放疗/脉冲式低剂量率放疗Key words
recurrence/glioma/recurrent radiotherapy/pulse low-dose rate radiotherapy分类
医药卫生引用本文复制引用
周培杰,李云天,包娅薇,郭丹玉,钱中润..术后复发性脑胶质瘤治疗新策略——脉冲式低剂量率再程放疗[J].临床神经外科杂志,2024,21(4):402-406,5.基金项目
国家自然科学基金青年科学项目(82102953) （82102953）
