IMRT结合后程γ-刀推量放射治疗术后脑胶质瘤的疗效研究  

The Efficacy of Postoperative Intracranial Glioma Treated by the Intensity Modulated Conformal Radiotherapy(IMRT) Combined with γ-Knife Integrated Boost Radiotherapy

作　　者：张保祯[1] 蒋效华 

机构地区：[1]内蒙古医科大学附属医院放疗科,内蒙古呼和浩特010050

出　　处：《内蒙古医学杂志》2015年第4期388-392,共5页Inner Mongolia Medical Journal

摘　　要：目的探索调强适形放疗（IMRT）后程结合γ刀推量放射治疗术后高级别脑胶质瘤的疗效，并探讨其预后影响因素。方法选择2007年6月至2010年6月问我院放疗科收治的60例术后病理证实为Ⅲ～Ⅳ级脑胶质瘤，且未口服过替莫唑胺化疗的患者，对照组30例采用单纯IMRT放疗方法；观察组30例采用IMRT结合后程γ刀推量放疗方法，比较两组的近期疗效（3个月后MRI复查结果）及1年、2年、3年生存率，并用COX模型对综合组进行预后多因素分析。结果观察组3个月总有效率为70．0％（21／30）；对照组3个月总有效率为23．3％（7／30），两组之间比较差异具有统计学意义（Y2=13．125，P〈0．05），观察组与对照组1年、2年、3年生存率分别为76．67％（23／30）、63．33％（19／30）、30．00％（9／30）；70．00％（21／30）、56．67％（17／30）、23．33％（7／30），两组之间比较差异具有无统计学意义（X^2=0．341，P〉0．05；X^2=0．278，P〉0．05；X^2=0．341，P〉0．05），COX模型对综合组进行预后多因素分析显示：年龄、病理类型与预后有关，KPS评分、性别与预后无密切关系。结论IMRT放疗结合γ刀推量放射治疗未口服过替莫唑胺的术后高级别脑胶质瘤，明显提高了病灶局部控制率（近期疗效），但远期疗效（1年、2年、3年生存率）并未提高，COX模型对综合组进行预后分析显示。年龄、病理类型与预后有关．而KPS评分、性别与预后无关。Objective To explore clinical efficacy of postoperative high - grade intracranial glioma treated by the intensity modulated conformal radiotherapy （IMRT） combined with γ - knife Integrated boost radiother- apy, and to explore the prognostic factors. Methods 60 cases postoperative patients were selected, all of those were treated in our hospital radiotherapy department June 2007 - June 2010 and been pathologically confirmed grade Ⅲ -Ⅳ grade intracranial glioma and been not taken the oral temozolomide chemotherapy, 30cases of the control group were treated by IMRT Simply; 30cases of the observation group were treated by IMRT combined with γ- knife Integrated boost radiotherapy, short- term effect （MRI review results after 3 - months） and 1 - year, 2 - year, 3 - year survival rates were compared, multivariate prognostic factors were analyzed by using COX model. Results The 3 - months total effective rate was 70.0 % （21/30） in the observation group, 23.3 % （7/30） in the control group, the difference between the two groups was statistically significant （ X^2 = 13.125, P 〈 0.05 ）, 1 - year, 2 - year, 3 - year survival rates were respectively 76.67 % （ 23/30 ）, 63.33 % （19/30）, 30.00%（9/30） in the observation group; 70.00% （21/30）,56. 67% （17/30）、23.33% （7/30） in the control group, the difference between the two groups was not statistically significant（X^2 = 0. 341, P = 0. 559;X^2 = 0. 278, P = 0. 598;X^2 = 0.341, P = 0. 559）, multivariate prognostic factors analysis by using COX model on the observation group showed：age, pathological type were related with prognosis, KPS scores~ gender were not. Con- clusion IMRT radiotherapy combined with γ- knife Integrated boost radiotherapy significantly improved local tumor control rate （short - term effect） of postoperative patients who were pathologically confirmed grade In IV grade intracranial glioma and were not been taken the oral temozolomide chemotherapy, but the long - term efficacy （1 - year、2 - year、

关 键 词：脑胶质瘤 调强适形放疗 伽玛刀 

分 类 号：R739.4[医药卫生—肿瘤]