全中枢神经系统放疗副反应的治疗体会

The Management of Side Effect Attributable to the Whole Central Nervous System Radiotherapy

[目的]探讨全中枢神经系统放射治疗中的注意事项及副反应的处理。[方法]对34例行全中枢神经系统放射治疗的患者进行回顾性分析,脑髓母细胞瘤15例,室管膜母细胞瘤6例,松果体母细胞瘤8例,脑淋巴瘤5例,用6MV直线加速器行全中枢神经系统放疗,全中枢剂量给予30Gy～36Gy后缩野,对肿瘤原发灶追加剂量至50Gy～55Gy。[结果]除2例在治疗中死亡之外均能完成放疗,治疗中最严重的并发症为骨髓抑制。[结论]全中枢神经系统放射治疗可减少肿瘤复发,但放疗致骨髓抑制明显,须加强对症支持治疗,防止白细胞下降,避免患者死亡。

To assess the precaution and management of side effect attributable to whole central nervous system(WCNS)irradiation.Thirty-four patients undergoing WCNS(brain plus spinal cord)were retrospectively analyzed,including15cases with myeloblastomas,6cases with ependymoblastoma,8cases with pinealblastoma and5cases with brain lymphoma.All the cases were pathologically proved.WCNS irradiation(30Gy～36Gy)with6MV linear accelerator were given to the patients,boost dosage of50Gy～55Gy for primary lesion.All the cases completed the radiotherapeutic course except2patients died during the treatment.The serious complication was bone marrow depression.[Conclusions]WCNS radiotherapy can reduce tumor recurrence,but bone marrow depression is severe.Intensify support therapy to prevent neutropenia and death in irradiation should be carried out.