颅内原发恶性肿瘤X刀辅助分次放射治疗的初步经验

Study on X-Knife and Fractionated Radiotherapy in Patients with Primary Malignant Intracranial Neoplasms

目的 评价近 6年来采用X刀治疗后辅以常规分割放射治疗 85例颅内恶性肿瘤的疗效 ;方法 对 85例颅内恶性肿瘤均行单次X刀治疗 ,80 %等剂量线边缘剂量为 14～ 2 0Gy ;分割照射 3.0～ 3.5Gy/日 ,总剂量 2 0～ 4 0Gy/4～ 6周 ,部分病人辅以全脑照射 ,总剂量 15～ 30Gy/3～ 4周 ;结果 治疗后 3个月影像学复查肿瘤体积缩小 5 0 %以上为有效 ,本组总有效率为 6 2 /87(73% ) ,但随访期间肿瘤消失或缩小后出现复发或继续增大 12例 ,死亡 2 2例 ;结论 本方法有助于肿瘤局部控制率的提高和生存期的延长 。

Objective The survival benefit of combined X-knife radiosurgery and fractionated radiotherapy performed in 85 patients with primary malignant intracranial neoplasms were evaluated. Methods All of these patients had received initial X-knife therapy with a mean and median dose of 14～20Gy in 80% isodose. The fractionated radiotherapy was delivered by daily dose of 3.0～3.5 Gy, total dose of 20～40Gy/4～6 weeks. In some patients whole brain irradiation was delivered by dose level of 15～30Gy/3～4 weeks. Results The therapeutic effects were analysed at 3 months after X-knife radiotherapy. The effective rate was 73%(62/85) with tumor volume decreased more than 50%. Tumor recurrence or persistent growing occurred in 12 of the 62 patients. There were 22 of the 85 patients died. Conclusion The overall improvement of local control and prolong suvival period suggests that combined X-knife with ordinary fractionated radiotherapy is an effective and safe approach for treatment of malignant intracranial neoplasms.