低能量X-射线术中放射治疗在恶性胶质瘤的应用与安全性研究  

The application and safety of low-energy X-ray intraoperative radiotherapy in the treatment of malignant glioma

作　　者：王强 丁巍 刘凤 马驰原 孙向东 潘灏 Wang Qiang;Ding Wei;Liu Feng;Ma Chiyuan;Sun Xiangdong;Pan Hao(Department of Neurosurgery,Jinling Hospital,School of Medicine,Nanjing University,General Hospital of Eastern Theater Command,Nanjing,Jiangsu 210002,China;Department of Radiation Oncology,Jinling Hospital,School of Medicine,Nanjing University,General Hospital of Eastern Theater Command,Nanjing,Jiangsu 210002,China)

机构地区：[1]东部战区总医院南京大学医学院附属金陵医院神经外科,江苏南京210002 [2]东部战区总医院南京大学医学院附属金陵医院放射治疗科,江苏南京210002

出　　处：《中国微侵袭神经外科杂志》2023年第12期28-34,共7页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：东部战区总医院课题(编号:22LCZLXJS66)

摘　　要：目的评估术中放疗(intraoperative radiotherapy,IORT)治疗恶性胶质瘤的安全性及初期不良反应。方法恶性胶质瘤患者常规开颅手术切除肿瘤后,采用低能量X-射线术中放疗系统(Low-energy X-ray intraoperative radiotherapy,LEX-IORT)进行IORT。记录患者术后状态及初期不良反应情况,并与既往未行IORT的恶性胶质瘤患者(常规组)相关情况作比较。结果共纳入14例恶性胶质瘤患者,男8例,女6例。所有患者接受20Gy的IORT。IORT组平均手术时间(262.1±55.6)min,常规组(222.6±53.5)min(P=0.061)。IORT组患者术后平均住院时间为(13.9±5.6)d,常规组为(10.3±4.7)d(P=0.071)。IORT组患者术后未发生颅内感染、脑积水、术后癫痫发作、脑出血及切口感染。1例患者在同步放化疗期间切口裂开,未发生感染,予以重新缝合,停用安罗替尼,正常愈合,未影响放疗。两组患者均按计划完成同步放化疗。结论20Gy LEX-IORT对恶性胶质瘤患者是安全的,不会增加额外并发症。Objective To evaluate the safety and initial adverse effects of intraoperative radiotherapy(IORT)for malignant glioma.Methods Malignant glioma patients received low-energy X-ray intraoperative radiotherapy(LEX-IORT)after conventional craniotomy for tumor resection.Patients'postoperative status and complications were recorded and compared with those of malignant glioma patients who had not receive intraoperative radiotherapy(the conventional surgery group).Results A total of 14 malignant glioma patients,8 males and 6 females,were enrolled in this study.All patients received IORT of 20Gy.The average surgical duration was 262.1±55.6 min in the IORT group and 222.6±53.5 min in the conventional surgery group(P=0.061).The average postoperative hospital stay was 13.9±5.6 days in the IORT group and 10.3±4.7 days in the conventional surgery group(P=0.071).The patients in the IORT group did not have postoperative intracranial infection,hydrocephalus,postoperative seizures,cerebral hemorrhage and incision infection.One patient’s incision was dehiscenced during concurrent chemoradiotherapy and no infection occurred.The incision re-healed after replacing the suture and discontinuation the use of Anlotinib,without affecting radiotherapy.All patients of both groups had completed standard radiotherapy with concomitant temozolomide as planned.Conclusion LEX-IORT at a dose of 20Gy is generally safe for patients with malignant glioma without adding additional complications.

关 键 词：神经胶质瘤 恶性 术中放疗 低能量X-射线 安全性 

分 类 号：R739.41[医药卫生—肿瘤]