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目的探讨高级别脑胶质瘤术后同步会师化放疗联合粒巨噬细胞集落刺激因子(granulocyte-macrophage colonystimulating factor,GM-CSF)治疗的效果及安全性。方法 92例显微手术全切经组织病理确诊为高级别脑胶质瘤患者随机分为2组,对照组46例术后应用尼莫司汀瘤腔联合替莫唑胺会师化疗同步放疗,观察组46例在对照组基础上给予GM-CSF治疗。记录2组治疗后3、6、9个月卡氏功能状态评分(Karnofsky performance status,KPS),随访观察无进展生存期及临床不良反应。结果观察组治疗6、9个月后KPS评分(75.38±8.96、79.81±8.28)均高于对照组(70.50±9.04、75.25±9.60)(P<0.05),观察组无进展生存期[(7.76±1.97)个月]较对照组[(6.93±1.76)个月]延长(P<0.05);随访期间2组均未发生Ⅲ度以上不良反应,观察组骨髓抑制发生率(10.87%)低于对照组(27.27%)(P<0.05)。结论高级别脑胶质瘤术后同步会师化放疗联合GM-CSF治疗可延长患者术后无进展生存期,提高生存质量,降低不良反应,改善预后。
Objective To investigate the efficacy and safety of simultaneous neuroradiotherapy combined with granulocyte-macrophage colony stimulating factor (GM-CSF) in the treatment of high-grade gliomas. Methods Ninety-two patients undergoing total microsurgical histopathological diagnosis of high-grade gliomas were randomly divided into two groups. 46 patients in the control group were treated with nimustine combined with temozolomide chemotherapy and concurrent radiotherapy. 46 patients On the basis of the control group given GM-CSF treatment. The Karnofsky performance status (KPS) at 3, 6, and 9 months after treatment were recorded. Progression-free survival and clinical adverse reactions were followed up. Results The KPS scores of observation group after treatment for 6 and 9 months (75.38 ± 8.96, 79.81 ± 8.28) were significantly higher than those in control group (70.50 ± 9.04 and 75.25 ± 9.60, P <0.05), respectively ± 1.97) months compared with the control group [(6.93 ± 1.76) months] (P <0.05). No grade Ⅲ or more adverse reactions occurred in the two groups during the follow-up period. The incidence of bone marrow suppression (10.87%) in the observation group was lower than that in the control group Control group (27.27%) (P <0.05). Conclusions High-grade gliomas combined with concurrent chemo-radiotherapy and GM-CSF can prolong postoperative progression-free survival, improve quality of life, reduce adverse reactions and improve prognosis.