Efficacy of Three- dimensional Conformal Radiotherapy Combined with Temozolomide in the Treatment of Diffuse Brainstem Glioma

Objective To investigate the efficacy of three- dimensional conformal radiotherapy combined with temozolomide in the treatment of diffuse brainstem glioma.Methods The clinical data of 21 brainstem glioma cases in our hospital from January 2006 to January 2010 were retrospectively analyzed.They were randomly divided into three- dimensional conformal radiotherapy group( 9 cases) and radiotherapy combined with temozolomide chemotherapy group( 12 cases).KPS scores were used to evaluate the quality of life.Survival time and adverse effect( the start of treatment until death) were determined through follow- up.Results Before treatment,there was no significant difference in KPS scores between radiotherapy group and chemotherapy and radiotherapy group 〔( 68.3 ± 5.0) vs.( 69.2 ± 6.3),t = 0.053,P 0.05〕.After six months treatment,the KPS of concurrent chemotherapy and radiotherapy group was significantly higher than the KPS of radiotherapy group 〔( 76.7 ± 13.0) vs.( 66.7 ±24.5),t =5.039,P 0.05〕.The adverse effects of chemotherapy were mainly nausea and vomit,as well as occasional headache,rash and hypocytosis,ⅠtoⅡ level.The adverse effects were alleviated after treatment.No adverse effect higher than level Ⅲ was found.During the three years follow up,18 cases died and 3 cases survived.The median survival time of the two groups was 19 months and 26 months respectively,showing statistically significant difference( P = 0.009).The one- year and two- year survival rate of radiotherapy group was 77.8% and 11.1% respectively,while the number for the concurrent chemotherapy and radiotherapy group was 83.3% and 50.0%.Conclusion Three- dimensional conformal radiotherapy combined with temozolomide chemotherapy can significantly improve the life quality of brainstem low- grade glioma( diffuse) patients and prolong their survival,with a good application prospect.