立体定向三维适形放射治疗30例脑胶质瘤  

Three-dimensional conformal radiotherapy for brain gliomas

作　　者：周陈华[1] 叶鸿[1] 马胜林[2] 朱远[2] 陈勇[1] 叶逢松[1] 陈晓钟[2] 吴爱菊[1] 叶碎林[1] 张诚[1] 

机构地区：[1]温州医学院附属六院放疗科,丽水市人民医院放疗科,浙江丽水323000 [2]浙江省肿瘤医院放疗科,浙江杭州310022

出　　处：《中国癌症杂志》2005年第6期535-537,共3页China Oncology

基　　金：浙江省医药卫生科学研究资金项目(NO:2002B79)。

摘　　要：目的:探索立体定向三维适形放射治疗脑胶质瘤的疗效和放射反应.方法:30例脑胶质瘤患者,其中术后残留者21例,术后复发者5例,放疗后复发者4例.利用CT模拟定位及三维重建,通过三维适形放射治疗系统,设放射野5～7个,采用圆形限光简同中心非共面照射7例,多叶光栏或挡铅技术照射23例.取包绕靶区(PTV)90%的等剂量曲线计算,PTV边缘剂量每次6 Gy,隔日1次,每周3次,共7次,总剂量42 Gy,相当于常规分割照射等效生物效应剂量(BED)56 Gy/28 F.结果:放射治疗后1～3个月内,根据MRI或MRI+CT复查;CR 12例(40.0%),PR 10例(33.3%),NC 6例(20.0%),PD 2例(6.7%).有效率(CR+PR)为73.3%.0.5、1、2、3年总生存率分别为93.3%,77.8%,71.31和53.18%.副反应除个别有轻度恶精,头昏外均未见其他严重副反应.结论:立体定向三维适形放射治疗脑胶质瘤是一种安全有效的方法,副反应小,能为大多数患者所耐受,有较好的近期疗效;远期疗效和后期放射损伤有待进一步观察.Purpose： To study the effects and effieat.y of three-dimensional conformal radiotherapy （3-DCRT） for brain gliontas. Methods： Thirty eases of brain gliomas were treated by three-dimensional conformal radiotherapy. Of these 21 patients had nesidual tumor arier operation, 5 were post-operative recurrent patients and 4 were post-radiotherapy recurrent patients. The total irradiation dose was 42 Gy（ BED 56 Gy）. All patients received 6 Gy/F. qod. Results： In the 1-3 months after 3-DCRT, the resuhs examined by CT or MRI shinned that in the 30 patients, these were CR 40. 0%, PR 33.3% , NC 20.0% , PD 6.7%, The total response rate was （ CR ＋ PR） 73.3% . No acute or chronic radiation side effects were observed in the follow up . The 0.5-, 1-. 2-, 3-year survival rates were 93.3%, 77.8%, 71.31%,53. 18% respectively. Conclusions： The result shows that 3-DCRT of braiu gliomas can improve therapeutie effect.

关 键 词：脑胶质瘤 三维适形放射治疗 预后 

分 类 号：R739.4[医药卫生—肿瘤]