不同分次剂量的立体定向放射治疗胶质瘤的临床研究

Clinical study of stereotactic radiotherapy using different fraction doses for gliomas

目的：探讨X线立体定向不同分次剂量放射治疗脑胶质细胞瘤的疗效。方法：对78例脑胶质细胞瘤患者,进行不同分次剂量的立体定向放射治疗。随机分为A、B、C三组,各组26例。A组分次剂量3.0Gy/次,5次/周,肿瘤总量DT45.0-50.0Gy;B组分次剂量5.0Gy/次,（3-4）次/周,肿瘤总量DT40.0Gy;C组分次剂量8.0Gy,2次/周,肿瘤总量DT32.0Gy。三组均采用非共面弧形旋转照射或固定野多野照射。另选一组为D组,常规放射治疗的患者共28例,肿瘤总量DT60.0Gy。结果：A、B、C、D组有效率分别为86.3%、83.3%、82.2%和73.2%,各组间有效率比较,差异无统计学意义,P〉0.05。1、2、3年生存率A、B、C、D组分别是92.3%、93.7%、77.9%、69.0%,84.5%、83.7%、57.8%、66.9%和80.0%、78.2%、41.7%、56.8%。A组与C组间生存率比较,3年生存率差异有统计学意义,P〈0.05。结论：不同分次剂量X线立体定向放射治疗,中等分次剂量疗效肯定。

OBJECTIVE： To explore the therapeatic effect of stereotactic radiotherapy by different fraction doses for gliomas. METHODS： Seventy-eight cases of gliomas were divided into A, B and C groups randomly, which included 26 cases respectively that received stereotactic radiotherapy by different fraction doses, using non-plate multi-Arc radiation by rotating linear accelerator arm or fixed fields of multi-position of bed. Group A got total DT 45-50 Gy, 3.0 Gy timely, 5 fractions weekly; Group B got total DT 40 Gy, 5.0 Gy timely, 3-4 fractions weekly; Group C got total DT 32 Gy, 8.0 Gy timely, 2 fractions weekly. Another group was D, using traditional radiation including 28 cases which got total DT 60 Gy. RESULTS： The effective rates of A, B, C and D groups were 86.3%, 83.3%, 82.2% and 73.2% respectively, and there were no statistical differences among these groups, P〉0.05. 1-, 2-, 3-year survival rates were 92.3%, 93.7%, 77.9%, 69.0% and 84.5%, 83.7%, 57.8%, 66.9% and 80.0%, 78.2%, 41.7%, 56.8%, and there was a statistical difference for 3-year survival rates between Group A and Group C （P〈0.05）. CONCLUSION： The median fraction doses are optimal option for X-ray stereotactic radiotherapy by different fractions doses.