星形细胞瘤术后放射性脑坏死的临床特点分析

Clinical features of radiation encephalopathy after operation of astrocytoma

目的探讨星形细胞瘤术后放射性脑坏死的临床特点及与肿瘤复发的鉴别诊断方法，为临床治疗提供参考。方法收集22例经病理证实的放射性脑坏死患者的临床资料，包括初次手术的影像资料、病理分级、放疗方法及剂量、以及再次手术前影像资料和病理报告，进行回顾性分析。结果22例患者中应用^60Co照射10例，应用直线加速器7例，应用伽马刀治疗5例，总剂量40～60Gy，平均51．5Gy。术后病理证实为放射性脑坏死。术后患者症状均有不同程度改善，随访仍有5例复发。结论星形细胞瘤术后放射性脑坏死可以通过临床特点、影像学检查与复发相鉴别。

Objective To study the clinical features of radiation encephalopathy and the differential diagnosis of the primary astrocytoma from the recurrent one after the operation. Methods Clinical data about 22 patients with pathologically confirmed radiation encephalopathy, including the image data before the initial operation, histological grade, method and dosage of radiotherapy, as well as the image data and pathology reports before the second operation, were retrospectively analyzed. Results 6o Co irra- diation was administered in 10 patients. Seven patients were given radiation therapy by using a linear accel- erator. Five patients were subjected to Gamma knife treatment. The total dose of radiation therapy was 40 - 60 Gy with the average of 51.5 Gy. The patients were pathologically confirmed to develop radiation enceph- alopathy after the operation. Postoperative symptoms were improved in varying degrees. During the follow up, astrocytoma reoccurred in 5 patients. Conclusion Radiation encephalopathy after the operation can be discriminated from the recurrent tumor by analyzing the clinical features and the image data.