影像引导下脑转移瘤大分割调强放疗  

Intensity-Modulated Radiation Therapy of Big Fraction for Brain Metastases with Image-Guided

作　　者：白晓平[1] 孔祥虎[1] 李珠明[1] 崔玉琴[1] BAI Xiao-ping;KONG Xiang-hu;LI Zhu-ming;CUI Yu-qin(Department of Radiation Oncology,Baotou Tumor Hospital,Baotou 014030 China)

机构地区：[1]包头市肿瘤医院放疗科,内蒙古包头014030

出　　处：《内蒙古医学杂志》2018年第11期1290-1292,共3页Inner Mongolia Medical Journal

基　　金：包头市卫生发展基金项目(wsjj2012005)

摘　　要：目的探讨影像引导下脑转移瘤大分割调强放疗的应用及疗效。方法将96例脑转移患者随机分为两组:大分割组50例,制定调强放疗计划,给予全脑照射40 Gy、2 Gy/次,脑转移部位60 Gy、3 Gy/次,共照射20次;常规组46例,制定常规放疗计划给予全脑照射40 Gy,2 Gy/次,共照射20次,然后,脑转移瘤部位补量20 Gy,2 Gy/次,共照射10次。所有患者每周行1次影像引导放射治疗。结果大分割组与常规组比较,X(左右方向)、Y(头脚方向)、Z(前后方向)3个方向偏差差别无显著性(P>0.05);大分割组总有效率78%(39/50)高于常规组52%(24/46)(P<0.01);两组I～Ⅱ度急性放射性脑损伤发生率无明显差异(P>0.05)。结论影像引导下大分割调强放疗能提高脑转移瘤放射治疗精度,提高局部控制率,安全可靠。Objective To investigate the use and efficacy by intensity-modulated radiation therapy of big fraction for brain metastases with Image-Guided.Methods A total of 96 patients who had brain metastases were divided into two groups randomly.50 patients of big fraction group were treated with intensity-modulated radiation therapy of big fraction with Image-Guided,whole brain was received dose of 40 Gy,the brain metastases were 60Gy,the time of treatment was 20 days.46 patients of conventional fraction group were treated with conventional radiation therapy of conventional fraction with Image-Guided,whole brain was received dose of 40 Gy,the time of treatment was 20 days,then,the brain metastases were was received dose of 20 Gy,the time of treatment was 10 days.All patients were received Image-guided radiation therapy one time every week.Result The error of center point position of each beam of big fraction group were as similar as conventional fraction group in three directions(P>0.05).The total effective powers of big fraction group and conventional fraction group were 78%(39/50)and 52%(24/46),respectively,the difference was statistically(P<0.01).The adverse effects rate of grades 1 to 2 brain damage in big fraction group were as similar as conventional fraction group(P>0.05).Conclusion The intensity-modulated radiation therapy of big fraction with Im-age-guided may improve precision of radiation therapy,raise rates of local control and ensure safety of treatment for brain metastases.

关 键 词：脑转移瘤 调强放疗 影像引导 

分 类 号：R739.41[医药卫生—肿瘤]