35例脑胶质瘤术后三维适形放射治疗

Three-Dimension Conformal Radiotherapy for 35 Cases with Brain Glioma

背景与目的:脑胶质瘤是颅内常见肿瘤,手术是主要的治疗手段,术后常需补充放射治疗。三维适形放疗是近几年发展起来的一种特殊放射治疗技术。本文旨在初步探讨三维适形放射治疗脑胶质瘤的疗效及不良反应。方法:35例脑胶质瘤患者,其中术后残留34例,术后放疗后复发1例,均接受三维适形放射治疗,予4～6个野共面或非共面照射,3例脑干肿瘤DT50～54Gy/25～27F,其他部位肿瘤DT56～60Gy/28～30F,每日一次,每周5次。结果:随访6～38个月,完全缓解25.7%(9/35),部分缓解48.6%(17/35),稳定14.3%(5/35),疾病进展8.6%(3/35),缓解率为74.3%;6个月、1年、2年生存率分别为94.3%、78.5%、53.9%。CT或MRI显示脑水肿9例,未见严重放射反应发生。结论:采用三维适形放射治疗技术治疗脑胶质瘤安全、有效,无严重不良反应。

BACKGROUND ＆ OBJECTIVE：Glioma is the commonest tumor in the brain. Surgery and radiotherapy is the mainstay of treatment for cerebral glioma. Three-dimension conformal radiotherapy （3-DCRT） is a special technique of radiotherapy. The study was to investigate the short-term therapeutic efficacy and side effects of three-dimension conformal radiotherapy （3-DCRT） for cerebral glioma. METHODS： Thirty five patients with glioma were treated by three-dimensional conformal radiotherapy in 4-6 fields. Thirty four patients had residual tumor after operation and one patient had local recurrent tumor after operation and conventional radiation therapy. Three brainstem tumors were treated with radiation dose of 50-54Gy/25-27F/ 5-6 weeks. Other patients were treated with the dose of 56-60 Gy/28-30F. RESULTS： The follow-up duration was 6-38 months. The complete response （CR）rate was 25.7%（9/35） and partial response（PR） rate was 48.6%（17/35）. Stable disease （SD） was 14.3%（5/35） and progressive disease（PD） was 8.6%（3/35）. So the objective response rate （CR＋PR） was 74.3%. The six-month, 1-year and 2-year survival rates were 94.3%, 78.5%, 53.9% respectively. Nine cases showed cerebral edema by CT or MRI exam. No radiation brain injury was recorded. CONCULUSIONS： The three-dimensional conformal radiotherapy is an effective and safe method in the treatment of brain glioma.