继发性脑肿瘤放射治疗36例体会

Radiotherapy for Secondary Brain Tumor

背景与目的:随着恶性肿瘤患者治疗效果的改善,生存时间延长,继发性脑肿瘤患者数量也有所增加,本文旨在评价继发性脑瘤放射治疗的临床意义。方法:对36例继发性脑肿瘤患者采用二或三阶段的放射治疗方式,第一段全颅放疗方法为每次1.8 Gy,共5次;第二段全颅放疗每次2 Gy,共18次,全颅总剂量45 Gy;第三阶段对单发灶患者给予小野追加放疗总剂量10-16 Gy。均为常规分割每天1次,每周5次,单发病灶者总剂量55-61Gy,多发病灶者总剂量45 Gy。结果:完成放疗计划31例,中断放疗5例,都在总剂量10-30 Gy时中断。症状明显好转或消失33例,6个月、1年和2年生存率分别为66.7%、25%、5.6%,平均生存时间 10.5个月。结论:继发性脑肿瘤放射治疗有效,可以延长患者生存时间,改善生活质量。

BACKGROUND & OBJECTIVE: Incidence of secondary brain tumors increased in recent years because of the improvement in treatment outcome and prolonged survival of cancer patients. In this paper we evaluate the clinical significance of radiotherapy in secondary brain tumor by reviewing our clinical data. METHODS: Thirty-six cases of secondary brain tumors received radiotherapy. The radiotherapy schedule was as followings. The patient first received whole brain radiation with 1.8 Gy/fraction to a total dose of 9 Gy, and then followed by 2 Gy/fraction to a total dose of 36 Gy. Patient with solitary metastatic tumor was given additional local irradiation of 10-16 Gy by conventional daily fraction, 5 days per week. Hence, a total dose of 55-61 Gy was given to patient with solitory metastasis and a total dose of 45 Gy to patient with multiple metastases. RESULTS: Thirty cases finished radiotherapy and 5 cases stopped at the dose of 10-30 Gy. Symptoms improved or disappeared in 30 cases. The 0.5-, 1-, 2-year survival rates were 66.7% (24/36), 25% (9/36), 5.6%(2/36), respectively. The mean survival time was 10.5 months. CONCLUSION: Radiotherapy is effective and able to prolong the survival time and improve the quality of life in patients with secondary brain tumor.