26例脑膜瘤的质子放射治疗初步临床结果  

Primary results of proton radiotherapy for 26 meningioma patients

作　　者：高晶 胡集祎 杨婧 邱献新 胡微煦 陆嘉德 孔琳 Gao Jing;Hu Jiyi;Yang Jing;Qiu Xianxin;Hu Weixu;Lu Jiade;Kong Lin(Department of Radiation Oncology,Shanghai Proton and Heavy Ion Center,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy,Shanghai 201315,China;Department of Radiation Oncology,Shanghai Proton and Heavy Ion Center,Fudan University Cancer Hospital,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy,Shanghai 201315,China)

机构地区：[1]上海市质子重离子医院放射治疗科,上海质子重离子放射治疗工程技术研究中心,201321 [2]上海市质子重离子医院暨复旦大学附属肿瘤医院质子重离子中心放射治疗科,上海质子重离子放射治疗工程技术研究中心,200032

出　　处：《中华放射医学与防护杂志》2020年第4期302-307,共6页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的考察质子射线放射治疗世界卫生组织(WHO)Ⅰ/Ⅱ级脑膜瘤的初步疗效及不良反应。方法回顾性分析2015年5月至2018年10月上海市质子重离子医院治疗脑膜瘤患者26例,其中18例为颅底脑膜瘤。患者的中位年龄为42岁(范围15~79岁)。病理诊断为WHOⅠ级脑膜瘤的患者8例,病理诊断为WHOⅡ级的脑膜瘤患者9例,影像学诊断患者9例。7例患者为术后放疗(SimpsonⅠ~Ⅲ级切除2例,SimpsonⅣ~Ⅴ级切除5例),10例患者为术后复发后放疗。结果中位随访时间为22.2个月,所有患者均完成了既定的质子射线放射治疗,中位等效剂量为54 GyE(范围50.4~60 GyE),单次剂量为1.8~2.0 GyE。治疗后70%患者症状部分缓解,2年无进展生存率(PFS)和总生存率(OS)均为100%。治疗期间急性放射反应轻微,仅出现1级脱发(n=22)和黏膜反应(n=2),无2级及以上急性反应,目前尚未观察到晚期不良反应。结论质子治疗颅内及颅底脑膜瘤安全有效,长期疗效及不良反应需进一步随访。Objective To investigate the safety and efficacy of proton beam radiation therapy(PBRT)in patients with World Health Organization(WHO)GradeⅠ/Ⅱmeningioma.Methods Twenty-six patients with intracranial(n=8,30.8%)or skull-base(n=18,69.2%)meningioma treated with PBRT from May 2015 to October 2018 were analyzed retrospectively.The median age of the cohort was 42 years(range 15-79 years).Eight patients had WHO GradeⅠmeningioma,and 9 had WHO GradeⅡmeningioma,respectively.Nine patients had clinical(radiological)diagnosis without histology.Seven patients received post-surgical PBRT(2 patients underwent SimpsonⅠ-Ⅲresection,5 patients underwent SimpsonⅣ-Ⅴresection);10 patients were irradiated for local recurrence after initial surgical resection.Results All patients completed planned PBRT without break,and the median dose was 54 GrayEquivalent(GyE)(range 50.4-60 GyE,1.8-2 GyE/daily fraction).With a median follow-up of 22.2(range 1.6-36.4)months,the 2-year overall survival and progression-free survival rates were both 100%.GradeⅠskin erythema and alopecia were observed in 22 patients and GradeⅠmucositis was observed in 2 patients.No acute of late toxicities of Grade 2 or above was observed.Conclusions PBRT appeared to be a favorable treatment option for intracranial and skull base meningioma.Treatment-induced adverse effects and early response to PBRT were both highly acceptable.Longer follow-up is needed to evaluate the long-term outcome in terms of disease control,survival,as well as potential late effects.

关 键 词：质子治疗 脑膜瘤 不良反应 疗效 

分 类 号：R73[医药卫生—肿瘤]