58例胶质瘤不同分割剂量调强放疗疗效观察  

Effect of Intensity-modulated Radiotherapy with Different Dose Fractionations on Astrocytic Tumors

作　　者：刘云琴[1] 钱立庭[1] 张红雁[1] 马军[1] 赵于飞[1] 吴韦炜[1] 

机构地区：[1]安徽医科大学附属安徽省立医院放疗科,合肥市230001

出　　处：《中国肿瘤临床》2010年第7期395-398,共4页Chinese Journal of Clinical Oncology

基　　金：安徽省科技攻关计划资助(编号:0701302202)

摘　　要：目的:评价星形胶质细胞瘤的不同分割剂量调强放射治疗(IMRT)疗效和副作用。方法:2001年10月至2006年12月,58例经病理证实的星形胶质细胞瘤接受了IMRT治疗。根据世界卫生组织(WHO)分类,其中Ⅱ级32例,Ⅲ级20例,Ⅳ级(胶质母细胞瘤)6例。58例中大分割IMRT治疗32例(包括Ⅳ级3例、Ⅲ级11例、年龄大于40岁的Ⅱ级18例);常规分割IMRT治疗26例。结果:1、3和5年总生存率(OS)分别为86%、52%和45%,1、3和5年无进展生存率(PFS)分别为77%、38%和25%。分层分析显示WHOⅡ级患者大分割组疗效优于常规分割组,两组OS和PFS差异有统计学意义(P=0.049和P=0.006);WHOⅢ级患者大分割组的OS和PFS高于常规分割组,但差异无统计学意义。只有1例患者出现了晚期RTOG 3级神经毒性。结论:与常规分割IMRT相比,大分割IMRT有可能提高星形细胞瘤的总生存率和无进展生存率。Objective： To investigate the outcome and adverse effects of IMRT with different dose fractionations for astrocytic tumors. Methods： From October 2001 to December 2006, 58 patients with astrocytic tumor were treated with IMRT in our hospital. According to the World Health Organization （WHO） classification, there were 32 grade Ⅱ cases, 20 grade Ⅲ cases and 6 grade Ⅳ cases （glioblastoma multiforme, GBM）. Thirty-two of 58 patients （3 grade Ⅳ cases, 11 grade Ⅲ cases and 18 grade Ⅱ cases older than 40 years） were treated with hypofractionated IMRT, 26 patients were treated with standard fractionation IMRT. Results： The 1-, 3- and 5-year overall survival （OS） rates were 86%, 52% and 45% respectively. The 1-, 3- and 5-year progression-free survival （PFS） rates were 77%, 38% and 25%, respectively. Patients of grade Ⅱ treated with hypofractionated IMRT had better OS and PFS （P=0.049 and P=-0.006）. Patients of grade Ⅲ treated with hypofractionated IMRT had a better OS and PFS, but was not statistically significant （P〉0.05）. One patient experienced Radiation Therapy Oncology Group （RTOG） grade HI late neurotoxicity. Conclusion： Compared with standard fractionation IMRT, hypofractionated IMRT is helpful for prolonging the survival of patients with astrocytoma.

关 键 词：星形胶质细胞瘤 调强放射治疗 大分割 

分 类 号：R737.9[医药卫生—肿瘤]