3DCRT预防脑胶质瘤术后复发的临床初探  

Clinical analysis of 3 dimensional conformal radiation therapy and stereotactic radiosurgery preventivedpostoperation brain glioma relapsed

作　　者：林震涛[1] 梅文忠[1] 林丛[1] 程惠华 李东石 陈龙飞[1] 林弘[1] 叶圣华[1] 

机构地区：[1]福建医科大学附属第一医院,福州350000 [2]东方医院军区总院

出　　处：《中国临床实用医学》2008年第2期6-8,共3页China Clinical Practical Medicine

基　　金：福建省重点项目（项目编号：2006Y01041473）

摘　　要：目的探索三维适形放射治疗（3 dimensional conformal radiation therapy，3DCRT）是否对脑胶质瘤术后复发有控制作用。方法回顾性分析97例脑胶质瘤术后加用三维适形放射治疗的近、远期疗效及并发症。应用美国MED-TEC面网固定头颅，行薄层CT扫描，必要时行加强CT扫描，将CT数据转输至工作站，勾画靶区及重要的解剖结构，给靶区正常剂量及重要解剖结构限制剂量，优化治疗方案。在Varian600cd直线加速器的120叶多叶光珊上，行25～33次，分次治疗，每次剂量为200cGy，采用每周5次的分割方式治疗。结果经三维适形放射治疗，1年后复查临床症状改善93例（95．9％），无变化3例（3．1％），恶化1例（1．03％），死亡0。影像学结果：完全消失31例，缩小50例，无变化14例，进展3例；2年后复查：临床症状改善53例，无变化12例，恶化21例，死亡11例。影像学结果：完全消失33例，缩小25例，无变化6例，进展33例；3年后复查：临床症状改善46例，无变化15例，恶化4例，死亡32例。影像学结果：完全消失33例，缩小22例，无变化3例，进展39例。结论颅内脑胶质瘤术后均行3DCRT治疗。术后1年内无死亡。1、2、3、年生存率分别为：100％、88．66％、67％。立体三维适形放射治疗是一种较为理想的治疗方法，其疗效较高，并发症少：Objective To probe whether the 3 dimensional conformal radiation therapy（3DCRT） control postoperative patients with glioma of the brain, Methods To analyze the prostecdtive efficacy and complication of the 3 dimensional conformal radiation therapy on 97 postoperative patients with glioma of the brain retro-spectively, Lamellar scanning brain by CT after fixed the head by MED-TEC face cage, then transfer data to workstation, to draw anatomic structure of target region, Give a certain dosage to the target region, , optimize therapeutic regimen by inverse calculate,and then cure by accelerator linear. C ombinated with mannitol and hormone therapy, The average total dose of radiation was 25-33 time,with 200 Gy each time,one week five times, Results After the 3 dimensional conformal radiation therapy,follow-up visit by clinical symptom show after one year, 93 cases,95.9 percent of clinical symptom improved,3 cases,3. 1 percent had no change, 1 cases aggravated, 1. 03 % percent and none death, Follow-up visit by imageology show ： completely elimination 31 cases, diminution 50 cases, 14 cases had no change,3 cases aggravated. Follow-up visit by clinical symptom show after two years, 53 cases clinical symptom improved, 12 cases had no change ,21 cases aggravated, 11 cases death. Follow-up visit by imageology show：completely elimination 33cases,diminution 25 cases,6 cases had no change,33 cases aggravated, Follow-up visit by clinical symptom show after two years,46 cases clinical symptom improved, 15 cases had no change,4 cases aggravated,32 cases death, Follow-up visit by imageology show：completely elimination 33cases,diminution 22 cases, 3 cases had no change,39 cases aggravated. Conclusion All postoperative patients with glioma of the brain were treated by 3 DCRT, no palindromia during one year after operation, 3 dimensional conformal radiation therapy is a ideal way to cure the glioma of the brain after operation for its high curative effect and low complication, Three dimensional conformal radiotherapyis a

关 键 词：三维适形放射治疗 3DCRT 脑胶质瘤 术后复发 预防 

分 类 号：R739.4[医药卫生—肿瘤]