容积旋转调强放射治疗对脑胶质瘤的干预效果及对患者生活质量的影响
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摘要
目的研究容积旋转调强放射治疗对脑胶质瘤的干预效果及对患者生活质量的影响。方法选择2016年3月至2018年3月在浙江省湖州市第三人民医院诊治的脑胶质瘤患者65例为研究对象。通过随机数字表法分为观察组(33例)和对照组(32例)。对照组采用调强适形放射治疗,观察组采用容积旋转调强放射治疗。比较2组治疗后疗效、生活质量评分、中位生存期及不良反应发生情况。结果治疗后,观察组总有效率高于对照组[90. 9%(30/33)比62. 5%(20/32)],差异有统计学意义(P <0. 05)。治疗后,2组患者躯体功能、角色功能、情绪功能、社会功能、认知功能方面的生活质量评分均高于治疗前,且观察组高于对照组,差异均有统计学意义(均P <0. 05)。观察组患者中位生存期明显长于对照组[(18. 4±3. 3)个月比(14. 2±2. 1)个月],差异有统计学意义(P <0. 01)。治疗期间,观察组不良反应总发生率低于对照组[18. 2%(6/33)比65. 6%(21/32)],差异有统计学意义(P <0. 01)。结论在脑胶质瘤患者中应用容积旋转调强放射治疗,疗效显著,可改善患者生活质量。
Objective To explore the therapeutic effect of volume-rotation intensity-modulated radiotherapy on patients with glioma and the effect on quality of life. Methods A total of 65 patients with glioma diagnosed in Huzhou Third People's Hospital,Zhejiang Province,from March 2016 to March 2018 were randomly divided into observation group( 33 cases) and control group( 32 cases). The control group was treated with intensity-modulated conformal radiotherapy; the observation group was treated with volume-rotation intensity-modulated radiotherapy.Clinical efficacy,quality of life score,median survival and adverse reactions were analyzed. Results After treatment,the total effective rate in observation group was significantly higher than that in control group[90. 9%( 30/33) vs 62. 5%( 20/32) ]( P < 0. 05). Scores of physical function,role function,emotional function,social function and cognitive function were significantly improved after treatment in both groups and the scores in observation group were significantly higher than those in control group( all P < 0. 05). Median survival time in observation group was significantly longer than that in control group [( 18. 4 ± 3. 3) months vs( 14. 2 ±2. 1) months]( P < 0. 01). Incidence of adverse reactions in observation group was significantly lower than that in control group[18. 2%( 6/33) vs 65. 6%( 21/32) ]( P < 0. 01). Conclusion Volume-rotation intensity-modulated radiotherapy is effective in the treatment of glioma and it can significantly improve the quality of life.
Objective To explore the therapeutic effect of volume-rotation intensity-modulated radiotherapy on patients with glioma and the effect on quality of life. Methods A total of 65 patients with glioma diagnosed in Huzhou Third People's Hospital,Zhejiang Province,from March 2016 to March 2018 were randomly divided into observation group( 33 cases) and control group( 32 cases). The control group was treated with intensity-modulated conformal radiotherapy; the observation group was treated with volume-rotation intensity-modulated radiotherapy.Clinical efficacy,quality of life score,median survival and adverse reactions were analyzed. Results After treatment,the total effective rate in observation group was significantly higher than that in control group[90. 9%( 30/33) vs 62. 5%( 20/32) ]( P < 0. 05). Scores of physical function,role function,emotional function,social function and cognitive function were significantly improved after treatment in both groups and the scores in observation group were significantly higher than those in control group( all P < 0. 05). Median survival time in observation group was significantly longer than that in control group [( 18. 4 ± 3. 3) months vs( 14. 2 ±2. 1) months]( P < 0. 01). Incidence of adverse reactions in observation group was significantly lower than that in control group[18. 2%( 6/33) vs 65. 6%( 21/32) ]( P < 0. 01). Conclusion Volume-rotation intensity-modulated radiotherapy is effective in the treatment of glioma and it can significantly improve the quality of life.
引文
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[10]王锐濠,张书旭,田允鸿,等.单双弧设定对胸段食管癌容积旋转调强计划的剂量学比较[J].中国医疗设备,2017,32(12):40-43. DOI:10. 3969/j. issn. 1674-1633. 2017. 12. 009.Wang RH,Zhang SX,Tian YH,et al. Dosimetric comparison of single-arc and double-arc VMAT plan for treatment of thoracic esophageal cancer[J]. China Medical Devices,2017,32(12):40-43. DOI:10. 3969/j. issn. 1674-1633. 2017. 12. 009.
[2]Eckel-Passow JE,Lachance DH,Molinaro AM,et al. Glioma groups based on 1p/19q,IDH,and TERT promoter mutations in tumors[J]. N Engl J Med,2015,372(26):2499-2508. DOI:10. 1056/NEJMoa1407279.
[3]孟令新,韩菁,周丹丹,等.中下段食管鳞癌患者行三维适形调强放射疗法与发生放射性肺损伤的相关性[J].中国医药,2018,13(1):80-84. DOI:10. 3760/cma. j. issn. 1673-4777.2018. 01. 022.Meng LX,Han J,Zhou DD,et al. Correlation between threedimensional conformal intensity-modulated radiotherapy and radiation-induced lung injury in patients with squamous cell carcinoma of middle and lower esophagus[J]. China Medicine,2018,13(1):80-84. DOI:10. 3760/cma. j. issn. 1673-4777. 2018. 01. 022.
[4]Platten M,Wick W,Weller M. Malignant glioma biology:Role for TGF-βin growth,motility,angiogenesis,and immune escape[J].Microsc Res Tech,2015,52(4):401-410.
[5]《中国中枢神经系统胶质瘤诊断和治疗指南》编写组.中国中枢神经系统胶质瘤诊断和治疗指南(2015)[J].中华医学杂志,2016,96(7):485-509. DOI:10. 3760/cma. j. issn. 0376-2491. 2016. 07. 003.Compilation group of guidelines for diagnosis and treatment of central nervous system gliomas in China. Guidelines for diagnosis and treatment of central nervous system gliomas in China(2015)[J].National Medical Journal of China,2016,96(7):485-509. DOI:10. 3760/cma. j. issn. 0376-2491. 2016. 07. 003.
[6]白庆岭,胡长伟,彭营影,等.脑胶质瘤预后影响因素分析[J].临床误诊误治,2018,31(7):91-94. DOI:10. 3969/j. issn.1002-3429. 2018. 07. 025.Bai QL,Hu CW,Peng YY,et al. Analysis of prognostic factors of brain glioma[J]. Clinical Misdiagnosis&Mistherapy,2018,31(7):91-94. DOI:10. 3969/j. issn. 1002-3429. 2018. 07. 025.
[7]刘振清,刘鸿圣.动态对比增强MRI诊断脑胶质瘤的研究进展[J].中国医学影像技术,2016,32(10):1617-1620.Liu ZQ,Liu HS. Research progress of dynamic contrast-enhanced MRI in diagnosis of glioma[J]. Chinese Journal of Medical Imaging Technology,2016,32(10):1617-1620.
[8]Liu M,Dai B,Kang SH,et al. Fox M1B is overexpressed in human glioblastomas and critically regulates the tumorigenicity of glioma cells[J]. Cancer Res,2006,66(7):3593-3602.
[9]周莉,杜天幸,朱小鹏.高强度聚焦超声联合调强适形放射治疗中晚期肝癌的临床研究[J].疑难病杂志,2015,14(12):1255-1258. DOI:10. 3969/j. issn. 1671-6450. 2015. 12. 015.Zhou L,Du TX,Zhu XP. Clinical study of high intensity focused ultrasound combined with IMRT treatment of advanced hepatocellular carci-noma[J]. Chinese Journal of Difficult and Complicated Cases,2015,14(12):1255-1258. DOI:10. 3969/j. issn. 1671-6450.2015. 12. 015.
[10]王锐濠,张书旭,田允鸿,等.单双弧设定对胸段食管癌容积旋转调强计划的剂量学比较[J].中国医疗设备,2017,32(12):40-43. DOI:10. 3969/j. issn. 1674-1633. 2017. 12. 009.Wang RH,Zhang SX,Tian YH,et al. Dosimetric comparison of single-arc and double-arc VMAT plan for treatment of thoracic esophageal cancer[J]. China Medical Devices,2017,32(12):40-43. DOI:10. 3969/j. issn. 1674-1633. 2017. 12. 009.