脑瘤术后超分割加三维适形放疗疗效分析

Hyperfractionated and three-dimension conformal radiotherapy in treatment of brain neoplasm

目的探讨脑瘤术后超分割加三维适形放疗(3-DCRT)的疗效及不良反应。方法脑瘤术后病例60例,随机分A组30例,B组30例。A组接受超分割加3-DCRT,剂量DT66～74Gy;B组接受常规放疗,剂量DT56～60Gy,对比两组的疗效及不良反应。结果肿瘤消退率:A组86.7,B组60.0,差异有统计学意义(P<0.05);1、3、5年总生存率:A组分别80.0、53.3、30.0;B组分别为60.0、46.7、26.7;5年局部复发率:A组43.3,B组53.3,差异无统计学意义(P>0.05);脑水肿发生率:A组36.7,B组30.0,差异无统计学意义(P>0.05)。结论超分割加3-DCRT治疗脑瘤术后,近期疗效优于常规放疗,两组脑水肿发生率无统计学意义。

Objective To investigate the therapeutic efficacy and side effects of hyperfractionated and three-dimension conformal radiotherapy for brain neoplasm. Methods Sixty patients with brain neoplasms were randomly divided into two groups. Thirty patients in Group A were treated by hyperfractionated and three-dimension conformal radiotherapy （3- DCRT） with a total dose of DT 66-74 Gy; 30 patients in Group B were treated with conventional radiotherapy with a total dose of 56-60 Gy. The efficacy and side effects of two groups were evaluated. Results The response rate of Group A and Group B were 86. 7% and 60. 0%, respectively （P 〈0. 05）. The 1-yeay, 3-year and 5-year survival rates of Group A and Group B were 80.0%,53.3%,30.0% and 60. 0%,46. 7%,26. 7%,respectively. The 5-year local relapse rates of Group A and Group B were 43.3% and 53.3% ,respectively, （P〉0.05）. The incidence of cerebral edema was 36.7% in Group A and 30.0% in Group B （P〉0. 05）. Conclusion The response rate of 3-DCRT in treatment of brain neoplasm is higher than that of the conventional radiotherapy,there is no difference in incidence of cerebral edema between two groups.