立体定向放射治疗复发性脑胶质瘤21例

Hypofractionated stereotactic radiotherapy for recurrent brain glioma

目的 :评价立体定向放射治疗复发性脑胶质瘤的效果和放射反应。方法 :1 998年 1 2月至 2 0 0 0年 1 2月治疗2 1例复发性脑胶质瘤患者 ,低分级者 1 2例 ,高分级者 9例 ,以 6 MVX、6～ 8个非共面照射野、85 %等剂量线包绕靶区、2 7～4 0Gy、3～ 5Gy/次、5～ 1 0次、7～ 1 4日。 结果 :全组患者的中位生存时间为 1 2个月 ,低分级和高分级胶质瘤分别为 1 6 5个月和 9个月 (P <0 0 2 )。直径≤ 3 5cm和 >3 5cm中位生存时间分别为 1 7个月和 9 5个月 (P <0 0 2 )。急性期放射反应均能耐受 ,未出现 3级以上的晚期放射损伤。结论 :分次立体定向放射治疗复发性脑胶质瘤是疗效较高 ,而放射反应较低的一种较好的姑息治疗方法。

Objective:To determine efficacy and toxicity of hypofractionated stereotactic radiotherapy(SRT) in patients with recurrent brain glioma.Methods:Between Dec. 1998 and Dec. 2000, we treated 21 patients with recurrent brain gliomas. Twelve had low grade glioma and nine high grade glioma. SRT was given using six to eight noncoplanar fixed beams at 3 to 5 Gy/fraction to dose ranging from 27 to 40 Gy, in five to seven fractions within seven to ten days.Results:The median survival of 21 patients with recurrent glioma was 12 months from the time of SRT. The median survival of 12 low grade and 9 high grade glioma was 16 5 months and 9 months individual ( P <0 02). Favorable predicting factors were small tumor volum,lower grade and higher Karnofsky Performance Scale (KPS) ( P <0 02). The treatment in all cases was well tolerated with acute effects. Toxicity was judged by RTOG criteria. No grade 3 toxicities were observed in these patients.Conclusion:SRT is moderate efficacy, acceptable toxicity method of palliative, high dose irradiation in the patients with recurrent gliomas.