不同分期髓母细胞瘤术后适形放疗联合化疗效果观察  

Postoperative three-dimensional conformal radiotherapy plus adjuvant chemotherapy for different stages of medulloblastoma

作　　者：刘建波[1,2] 王跃伟[1,2] 王伟[1,2] 刘明博[1,2] 李白羽[1,2] 

机构地区：[1]郑州大学人民医院 [2]河南省人民医院放疗科,郑州450003

出　　处：《中华实用诊断与治疗杂志》2015年第3期259-260,共2页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省科技厅基础与前沿技术研究计划项目(112300410296)

摘　　要：目的探讨不同分期髓母细胞瘤术后适形放疗30Gy联合化疗的临床疗效和不良反应。方法髓母细胞瘤患者56例分为低风险组22例和高风险组34例,术后均采用三维适形放疗联合化疗,观察治疗效果和不良反应。结果低风险组和高风险组5a生存率分别为81.8%(18/22)和44.1%(15/34),中位生存期分别为67、60个月,差异均有统计学意义(P<0.05);高风险组5a生存率M1期患儿为66.7%(12/18),M2期患儿为33.3%(3/9),M3期患儿为0;19例(33.9%)患儿发生Ⅰ、Ⅱ度骨髓抑制,7例(12.5%)发生Ⅲ度骨髓抑制,15例(26.8%)发生胃肠道反应。结论儿童髓母细胞瘤患者术后适形放疗30Gy联合化疗在低风险和高风险M1期患者疗效较好,高风险M2和M3期患者预后较差,治疗不良反应可耐受。Objective To investigate the effects and adverse reactions of postoperative three-dimensional conformal radiotherapy（3D-CRT）in a dose of 30 Gy plus chemotherapy for different stages of medulloblastoma.Methods Fifty-six patients with medulloblastoma were divided in low-risk group（n=22）and high-risk group（n=34）.Both groups received3D-CRT and adjuvant chemotherapy after operation,and were observed the therapeutic effect and adverse reactions.Results The 5-year survival rate and the mean survival time were 81.8%（18/22）and 67 months in low-risk group,significantly different from those in high-risk group（44.1%（15/34）,60months）（P〈0.05）.The 5-year survival rate was 66.6%（12/18）in stage M1,33.3%（3/9）in stage M2 and 0in stage M3 in high-risk group.The adverse reactions were stageⅠ and Ⅱ bone marrow depression in 19patients（33.9%）,stage Ⅲ bone marrow depression in 7patients（12.5%）and gastrointestinal reaction in 15（26.8%）.Conclusion The combination of 3D-CRT and adjuvant chemotherapy is effective for both low-risk and high-risk stage M1 patients.The prognosis of high-risk stage M2 and M3is poor.The adverse reactions are tolerable.

关 键 词：髓母细胞瘤 适形放疗 化疗 

分 类 号：R739.41[医药卫生—肿瘤]