放射外科治疗脑深部恶性胶质瘤疗效分析

The Outcome of Deep Situated Malignant Gliomas Treated with Radiosurgery

目的:研究直线加速器放射外科治疗脑深部恶性胶质瘤的疗效。方法:采用直线加速器放射外科治疗脑深部恶性胶质瘤58例,肿瘤平均体积12.08cm3,平均剂量19.42Gy。结果:随访期内44.8%肿瘤缩小,间变性星型细胞瘤MTP为15个月,胶质母细胞瘤MTP为9个月。1年肿瘤无进展生存率为37.9%,预期生存率为79.3%。2年肿瘤无进展生存率为10.3%,预期生存率20.6%。Cox回归分析等中心数和肿瘤体积对TTP有显著影响,而适形指数对患者生存期有显著影响。并发症发生率44.8%,脑水肿加重中位时间8个月,症状性脑水肿发生率31.0%。结论:直线加速器放射外科治疗脑深部恶性胶质瘤,可控制肿瘤生长,延长患者生存期。

Objective:To analysis the prog no sis for malignant gliomas treated with linac radiosurgery.Methods:58patient s with deep situated malignant glioma treated with linac radio-surgery,aged from7to70years,28anaplastic astrocytomas(AA)and30glioblastomas(GBM)w ere analysed.The mean volume of tumor was12.08cm 3 ,and mean prescription dose for linac radio-surgery was19.42Gy.Resul ts:44.8percent tumors shrank in follow-up.Median time-to-tumor progres sion(MTP)was10months,15months for AA and9months for GBM.The progression-free probability was37.9percent at1year and10.3percent at2years.M edian survival was22.5months for AA,13months for GBM and15months for al l patients.The survival probability was79.3percent at1year and20.6per cent at2years.Isocenter numbers and tumor volume were the prognostic factors for time-to-tumor progression,but conformity index was prognostic fac-tor for survival by Cox regression analysis.Complication appeared in44.8percent patients and the median interval of complication onset was8months.Symptomati c cerebral edema was ob-served in31.0percent patients.Conclusion:Linac radiosurgery can effectively improve MTTP and elongate survival for deep situate d malignant gliomas.Isocenter numbers and tumor volume are the prognostic fac tors for MTP,and conformity index is prognostic factor for survival.