术后射波刀立体定向放疗联合化疗治疗高级别胶质瘤研究  

CyberKnife stereotactic radiotherapy combined with chemotherapy for the treatment of high grade glioma after surgery

作　　者：刘秋华[1] 范学政[2] 梁平[3] 卢幻真[1] 程涛[1] 唐阳[1] Liu Qiuhua Fan Xuezheng Liang Ping et al(Department of Cy- berKni f e Center, Ruikang Hospital, Guangxi Traditional Chinese Medical University, Nanning, 530011, China)

机构地区：[1]广西中医药大学附属瑞康医院射波刀中心,南宁530011 [2]广西中医药大学附属瑞康医院神经外科,南宁530011 [3]广西中医药大学附属瑞康医院放疗科,南宁530011

出　　处：《立体定向和功能性神经外科杂志》2016年第5期277-280,共4页Chinese Journal of Stereotactic and Functional Neurosurgery

基　　金：广西自然科学基金资助项目(编号:2014GXNSFAA118146)

摘　　要：目的分析高级别胶质瘤术后射波刀立体定向放射治疗、普通直线加速器同步放射治疗加化学治疗的临床疗效。方法将31例高级别胶质瘤患者分为射波刀立体定向放疗（射波刀）组16例、普通直线加速器放射治疗同步加化学治疗（普放）组15例。射波刀组用立体定向放疗技术，放疔剂量11．3Gy／天，连续3天，总剂量33．9Gy；普放组用调强放疗技术，2Gy／天·次，30次，总剂量60Gy，周一～周五治疗，期间连用替莫唑胺42天。两组均在放疗后用替莫唑胺辅助化疗6个疗程。用Kaplan-Meier法和cOx模型进行生存分析。结果随访36～47（中位41）个月，射波刀组和普放组中位生存时间分别是15．55、14．7个月，1、2、3年生存率分别为56．3％、43．8％、37．5％及53．4％、40．2％、40．2％。两组对比，生存无明显差异（P〉0．05）。结论高级别胶质瘤术后，采用射波刀立体定向放射治疗或者普通直线加速器同步放射治疗加化疗，后续联合辅助化疗，两者疗效无明显差别。Objective To analyze the clinical effect of CyberKnife stereotaetic radiotherapy and linear accelerator concomitant radiochemotherapy for the treatment of high grade gliomas. Methods 31 cases of high grade glioma were divided into 16 cases of stereotactic radiotherapy （CyberKnife） group, 15 cases of linear accelerator concomitant radiochemotherapy （radiation therapy） group. CyberKnife group with stereotactic radiotherapy, radiotherapy dose 11. 3Gy / day,3 consecutive days,the total dose of 33.9Gy,radiation therapy group with intensity modula- ted radiation therapy, 2Gy/day, 30 times, total dose of 60Gy, Monday to Friday treatment, 42 days for the duration of the use of temozolomide capsul. The two groups were treated with 6 courses of temozolomide adjuvant chemotherapy after radiotherapy. Survival analysis was carried out using Kaplan--Meier method and COX model. Results Follow up ranged from 36 to 47 （median 41） months, the median survival time in the CyberKnife group was 15.5 months,and radiation therapy group was 14.7 months,respectively. There was no significant difference in survival between the two groups （P〉0. 05）. Conclusion High grade glioma after surgical treatment, use of Cy- herKnife stereotactic radiotherapy or linear accelerator concomitant radiochemotherapy, the clini- cal effect was no significant difference between the two group.

关 键 词：高级别胶质瘤 射波刀 立体定向放射治疗 生存分析 

分 类 号：R739.41[医药卫生—肿瘤]