螺旋断层放疗技术进行全中枢照射急性毒副反应的初步观察  

Observation of acute toxicity of craniospinal irradiation by helical tomotherapy

作　　者：黎静[1] 李志强[1] 文婷[1] 张晋建[1] 李重[2] 杨美玲[2] 项红霞[2] 贾峻嵩[1] 陈静[1] 徐艳红[1] 侯友贤[1] 

机构地区：[1]广州军区广州总医院螺旋断层放疗中心,510010 [2]广州中医药大学研究生院,510405

出　　处：《中国微侵袭神经外科杂志》2013年第2期72-74,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的观察螺旋断层放疗(Tomotherapy,Tomo)进行全中枢放疗(craniospinal irradiation,CSI)的急性毒副反应。方法回顾性分析6例实施Tomo治疗的病例资料,其中4例为生殖细胞瘤,2例为小脑髓母细胞瘤术后。临床靶区(clinicaltarget volumes,CTV)为术后瘤床(CTV1,50～56 Gy)、全脑和全脊髓(CTV2,28～36 Gy),每次1.8～2.0 Gy,1次/d,5次/周。毒副反应评价按通用不良反应术语标准3.0版本(CTCAE v3.0)。结果 2例因严重骨髓抑制未按计划完成全脑全脊髓照射。3级或3级以上反应:白细胞下降5例,贫血2例,血小板下降3例。恶心、呕吐均在2级和2级以下。病人均使用重组人粒细胞集落刺激因子,4例病人使用血小板集落刺激因子。结论 Tomo技术进行全脑、全脊髓照射需重视急性毒副反应。Objective To investigate the acute toxicity of craniospinal irradiation by helical tomotherapy. Methods Six patients, of whom 4 had intracranial germinoma and 2 had cerebellar medulloblastoma, were treated with craniospinal irradiation by helical tomotherapy. Prescription dose of clinical target volumes （CTV） comprising postoperative tumor bed （CTV1） was 50-56 Gy and whole craniospinal cord （CTV2） was 28-36 Gy with 1.8-2.0 Gy per fraction, 5 fractions per week. Toxicity was evaluated according to the Common Terminology Criteria for Adverse Events v3.0 （CTCAE v3.0）. Results The treatment was unfinished in 2 patients because of serious bone marrow suppression. Grade 3 or higher toxicity reactions were leucopenia in 5 cases, anemia in 2 cases and thrombocytopenia in 3 cases. Nausea and vomiting were at grade 2 or lower in all the patients. Recombinant human granulocyte colony-stimulating factor and human platelet colony-stimulating factor were.administered in 6 and 4 patients respectively. Conclusion Acute toxicity in craniospinal irradiation by helical tomotherapy must be taken into account seriously.

关 键 词：脑肿瘤 螺旋断层放疗 放射疗法 

分 类 号：R730.5[医药卫生—肿瘤]