The clinical observation of temozolomide combined with intensity-modulated radiotherapy in the treatment of malignant glioma with positive MGMT

Objective:To explore the effects of temozolomide(TMZ) combined with intensity-modulated radiotherapy(IMRT) on gliomas with postive O6-methylguanine-DNAmethyltransferase(MGMT). Methods:Thirty-four cases(including 13 cases anaplastic astrocytomas,11 cases anaplastic oligodendrogliomas and 10 cases glioblastomas multiforme) with Ⅲ-Ⅳ grade of MGMT-positive malignant gliomas diagnosed by immunohistochemical method were divided into treatment group(15 cases ) and control group(19 cases). The control group were treated with 95% PTV 60Gy/30f/42d in the head IMRT, and 75 mg/m2 of TMZ was added in the treatment group for 6 weeks(5 days, each week). The treatment group were treated with chemotherapy for 4 to 6 courses within 4 weeks after completing radiotherapy,150-200 mg/m2 was given for 5 days(28 days, each course). Results:The objective effective and disease control rate of the treatment and control group were 46. 67% ＆ 86. 67% and 42. 11% ＆ 84. 21%,respectively. The median survival time of the treatment and control group were 1. 5 and 1. 3 years, respectively. The one-year survival rate of the treatment and control group were 60% and 57. 89%,respectively. There was not statistical significance between two groups(P0. 05). Conclusions: The effects of TMZ combined with IMRT in the treatment of MGMT-positive malignant gliomas are better than that of IMRT alone.