间质内放射治疗深部脑肿瘤

Interstitial brachytherapy in treatment of deep brain tumors

的：了解间质内放射治疗脑深部肿瘤的效果，以利于提高间质内放射疗效。方法：在不同时间段，应用３ 种不同方式和剂量对 １７３ 例患者脑深部肿瘤进行间质内放射治疗，分期进行追踪随访。结果：全组无手术死亡，随访 ５～８２ 个月，其中星形细胞瘤Ⅰ～Ⅱ级 ３ 年生存率为 ５４．５％ ，５ 年生存率为３８６％ ；Ⅲ～Ⅳ级 １ 年生存率为１１．６％ ，２ 年生存率为７２０％ ，３ 年生存率为１６２％ 。影像学随访结果：肿瘤完全消失１５ 例（８．７％ ）；肿瘤直径缩小在８０％ 以上的２９ 例（１６．８％ ）；缩小３０％ ～５０％者８１ 例（４６．８％ ）。完全消失的肿瘤为颅内恶性淋巴瘤、松果体区生殖细胞瘤、部分成胶质细胞瘤和转移瘤等。结论：为减少照射后的并发症，提高治疗效果，对颅内不同部位和不同性质肿瘤的内放射治疗应选用不同的照射剂量，以超分割内照射加外照射方法较优。

Objective: To assess and improve the therapeutic effect of interstitial brachytherapy. Methods: A hundred and seventy three patients with deep brain tumors were treated with interstitial radio therapy through 3 different methods and at 3 different doses in different phases, they were followed up in different periods. Results: No operative death occured in all treated patients. Follow up of 5～82 months revealed that 3 years survival rate of astrocyte tumors patients of Ⅰ～Ⅱ degrees was 54.5%, the survival rate of 5 years was 38.6%; one year with Ⅲ～Ⅳ degrees was 11.6%, two years was 72.0%, three years was 16.2%. The result of radiology follow up survey indicated: fifteen cases with tumors completely disappeared (8.7%); 29 cases with tumors dimension shrinking over 80% (16.8%); 81 cases with shrinking 30%～50%(46.8%). Tumors of complete disapperance were intracranial malignant lymphoma, pineal cell tumors, multiform gliblastoma and metastatic tumors etc. Conclusion: To decrease the complications of radiation, improve the effect of treatment, different locations and properties of intracranial tumors should be treated with different radiation doses. The method of ultra segmentation plus extra radiation are better.