晚期胰腺癌术中放射治疗的疗效评价

目的 探讨术中放射治疗对晚期胰腺癌的疗效. 方法 对16例晚期胰腺癌患者作姑息性手术加术中放疗,用9-15Mev电子线照射病灶区域,照射20~25 Gy,并与同期未作术中放疗的20例姑息性手术治疗的患者(对照组)进行疗效比较. 结果 术中放疗组腰背痛及腹痛缓解率为93.8%(15/16),对照组腰背痛及腹痛缓解率为40.0%(8/20)(P<0.01),术中放疗组中位生存期为13.5月,对照组为8.6月(P<0.05). 结论 姑息手术联合术中放疗能有效地缓解晚期胰腺癌患者的腰背痛及腹痛,并可延长生存期.     

三维适形放射治疗胰腺癌临床探讨

目的探讨三维适形放射治疗（3 dimensional conformal radiotherapy，3DCRT）胰腺癌临床疗效。资料与方法55例胰腺癌病人（男42例、女13例）；39例病人先外照射DT 20～40 Gy后、再行3DCRT，9例行单纯3DCRT，7例外照射与3DCRT同时进行。单次照射剂量3～7 Gy、平均4．5 Gy，隔日照射1次、共3～14次；4～6个弧形或非共面适形固定野照射，照射总剂量21～48 Gy。结果所有病人疼痛快速缓解率为83．64％，有效率为96．36％。放疗后6～12个月复查CT，CR4例，PR 30例，NR 13例，PD 8例，总有效率为61．82％。Kaplan-Meier生存率分析，1、2、3年生存率分别为81．26％、24．38％、14．17％；存活时间最短4个月、最长49个月，中位生存期21个月；死亡36例，其中死于肝转移9例、多发转移12例、肿瘤局部进展11例、其他疾病4例。结论3DCRT胰腺癌具有缓解疼痛快、能提高肿瘤局部照射剂量和增加肿瘤局部控制率，在缩短疗程的同时、不增加近期放疗反应和远期并发症。     

体部立体定向适形放射治疗胰腺癌的临床探讨

目的 探讨立体定向适形放射治疗胰腺癌的近期疗效。方法 23例胰腺癌患者,先行外照射DT20－40Gy后、再行立体适形照射,单次剂量4－7Gy、隔日一次、共3－10次;5－6个弧形成非共面适形固定野照射,总量21－42Gy;全部患者均胺计划完成。结果 放疗后,多数患者胸背部疼痛明显减轻,缓解率为87％;放疗后2－3个月复查CT,多数和患者肿瘤无明显缩小;6个月1上时复查CT,有3例肿瘤缩小50％以上,2例不到50％;Kaplan-Meier生存率分析,1年和2年生存率分别为81.16%和26.63%;存活时间最长25个月1例、12个月以上5例、10个月3例、6个月以下4例,中位生存期15个月;死亡10例,其中死于肝转移5例、多发转移3例、心血管疾病2例。结论 立体定向适形放射治疗胰腺癌具有定位准确、重复性强、误差小,能提高肿瘤局部照射剂量和增加局部控制率,在缩短疗程的同时,不增加近期放疗反应和远期并发症。     

术中放射治疗晚期胰腺癌45例

目的　探讨术中放射治疗 (简称放疗 )对晚期胰腺癌的疗效。方法　使用直线加速器 ,对 1986～ 1997年期间收住我院 ,伴有严重背痛和腹痛的无法切除的晚期胰腺癌患者 45例进行术中放疗。结果　本组患者背痛和腹痛的完全缓解率为 5 6 % ,部分缓解率为 40 %。平均生存期为7 5个月。同期进行的 30例胰腺癌切除患者 ,其平均生存期为 7个月 ,两者差异无显著意义。结论　术中放疗尽管不能明显延长晚期胰腺癌患者的平均生存期 ,但能明显缓解患者的疼痛 ,提高患者的生活质量 ,仍然不失为一种有效的晚期胰腺癌姑息治疗方法。     

三维适形放疗同步化疗中晚期宫颈癌的临床研究

目的:比较三维适形放疗同步化疗和三维适形放疗在中晚期宫颈癌治疗中的疗效及副作用.方法:2004年1月至2010年6月,在我科住院的Ⅱb～Ⅳa不同期别宫颈癌118例,随机分为放化组及放疗组各59例,两组均采用全盆照射(40Gy/20次28～30天)、三维适形放疗(26～36Gy/13～18次,17～22天),放化组从放疗的第一周起进行化疗,化疗方案主要以含顺铂方案.结果:放化组、放疗组的近期有效率(CR+PR)均为100%,3年生存率为81.4%(48/59)、64.4%(38/59)(P=0.038),3年无瘤生存率分别为66.1%(39/59),、42.4%(25/59)(p=0.01 0);3年局部复发率分别为16.9%(10/59),、35.6%(21/59)(P=0.021);3年远处转移率分别为;15.3%(9/59)、30.5%(18/59)(P=0.049).结论:三维适形放疗同步化疗中晚期宫颈癌有较好疗效,毒副作用可以耐受.     

三维适形放疗加内分泌联合治疗晚期前列腺癌

目的评价三维适形放疗加内分泌联合治疗晚期前列腺癌的效果。方法对晚期前列腺癌患者25例行3DCRT 内分泌联合治疗(联合组),以同期进行的单纯内分泌治疗的晚期前列腺癌患者40例为对照组。随访时间3~48个月,中位随访期27个月。结果联合组3年生存率为88.0%,明显高于对照组(68.0%)。在30个月后,联合组的PSA低于对照组,差异有统计学意义(P<0.05)。结论3DCRT 内分泌联合治疗晚期前列腺癌疗效满意,优于单纯内分泌治疗。     

自拟抑肺汤联合化疗放疗治疗局部晚期非小细胞肺癌疗效分析

目的:评价自拟抑肺汤联合诱导化疗加三维适形放疗(3DCRT)治疗局部晚期非小细胞肺癌(NSCLC)的疗效及并发症.方法:92例局部晚期NSCLC患者随机分为单纯3DCRT组(RT组50例)和抑肺汤、诱导化疗与3DCRT联合组(联合组42例).联合组在3DCRT治疗前给以2～4个疗程铂类为主的化疗.结果:全组中位总生存期15个月,RT组中位总生存期12个月,联合组18个月(P=0.014).1年生存率RT组为48.6％,联合组为71.2％(P=0.004),2年生存率RT组为20.8％,联合组为37.6％(P=0.041).两组毒副反应相似,患者均能耐受.结论:抑肺汤、诱导化疗加三维适形放疗治疗晚期NSCLC可延长生存期,但并不增加放射副反应.     

XELOX/FOLFOX4方案新辅助同步放化疗对Ⅱ/Ⅲ期中低位直肠癌的疗效研究

目的初步探讨采用XELOX方案和FOLFOX4方案新辅助同步放化疗对Ⅱ/Ⅲ期中低位直肠癌的疗效及毒性反应。方法 2011年6月至2014年3月期间在青海省筇第五人民医院普通外科住院且拟行手术治疗的Ⅱ/Ⅲ期中低位直肠癌患者120例,采用随机数字表法随机分为放疗+FOLFOX4组手和放疗+XELOX组,术前均行同步放化疗.术前2组均采用三维适形放疗:1.8~2.0 Gy/次,5次/周.共25次,总剂量为45.0~50.0 Gy;同时分别按FOLFOX4方案(奥沙利铂+亚叶酸钙+5-氟尿嘧啶)或XELOX方案(卡培他滨片十奥沙利钼)行2个周期的同步化疗。同步放化疗结束后4~8周行直肠癌根治性手术二术后1个J月,放疗+FOLFOX4组又开始完成8~12个周期的FOLFOX4力方案化疗,放疗+XEI.OX组完成4~6个周期的XELOX方案化疗观察2组患荇的疗效及急·性毒性反应发生情况。结果①2组患者同步放化疗前的一般资料如性別比、年龄、cT分期、cN分期、TNM分期、组织(学类型、分化程度等比较差异均无统计学意义(P0.05)。②2组患者经同步放化疗后术前评估时发现,放疗+XELOX组患者cT和cN降期率均明显高于放疗+FOLFOX4组(P0.05)。③2组患者进行同步放化疗后行根治性手术后病理结果显示,放疗+XELOX组完全缓解率和有效-率均明娃岛显高于放疗+FOLFOX4组(P0.05)-④2组患者的1年总生存率比较差异无统计学意义(P0.05),但是放,疗+XELOX组的3年总生存率明显高于放疗+FOLFOX4组(P0.05);2组患者的3年无病生存率、远处转移率、局部复发率比较差异均无统计学意义(P0.05):⑤2组患者均出现,不同程度的毒性反应,均为3~4级毒性放疗+XELOX组总毒性反应发生率及腹泻发,生率明显低于放疗+FOLFOX4组(P0.05),均经对症治疗后好转,无一例患行者因术前同步放化疗而停止手术或死亡结论本研究的初步研究结果提示,对于中低位Ⅱ/Ⅲ期直肠癌患者采用术前同步放化疗,选择XELOX方案较FOLFOX4方案疗效更佳,急性毒性反应更低。     

三维适形放射疗法同时替加氟联合顺铂化学疗法治疗局部晚期胰腺癌的临床研究

目的：评价三维适形放射疗法同时替加氟联合顺铂化学疗法治疗局部晚期胰腺癌的疗效及毒性。方法：采用同时放化学疗法治疗局部晚期胰腺癌患者19例，放射治疗采用三维适形放射治疗，常规分割，共54～62 Gy；化学治疗第1～5天，替加氟800mg／d、顺铂20mg／d，21d为1个周期，共4个周期；化学治疗与放射治疗同时在第1天开始。结果：治疗总有效率36．8％；治疗前后CA199均数分别为425kU／L和79kU／L，差异有统计学意义；中位生存时间为10．9个月，1年生存率42．1％，2年生存率21．1％。结论：三维适形放射疗法同时替加氟联合顺铂化学疗法治疗局部晚期胰腺癌疗效与健择等其他同步化学治疗方案疗效相似，毒副反应患者能够耐受，值得进一步研究。     

非小细胞肺癌患者放疗导致放射性肺损伤的相关因素分析

目的探讨非小细胞肺癌患者三维适形放疗中各种因素对放射性肺损伤的预测价值。方法非小细胞肺癌患者118例采用三维适形方案放疗,6 MV X线,每次1.8~2 Gy,每周5次,保持总剂量为50 Gy以上。收集118例患者的相关临床因素,观察肿瘤的生物学因素以及肿瘤治疗的方案(包括放疗及其他治疗方式)等对放疗性肺损伤的影响,并对此因素进行单因素和多因素分析。结果发生肺损伤103例,发生率87.3%。单因素分析显示,仅大体肿瘤体积和部分剂量体积参数如患者的平均肺剂量、患肺V20和全肺平均肺剂量对放射性肺损伤有影响(P0.01),而其他因素影响不显著。多因素分析显示,剂量体积参数中仅平均肺剂量为放射性肺损伤独立相关因素(P0.05)。结论大体肿瘤体积、平均肺剂量、患肺V20和全肺平均肺剂量是非小细胞肺癌患者三维适形放疗后发生放射性肺损伤的危险因素。     

直肠癌术后局部复发综合治疗的疗效分析

目的：分析直肠癌根治术后局部复发的类型、综合治疗的疗效及预后。方法：对直肠癌术后局部复发、以往未接受过放疗的66例病人进行疗效分析。原手术方式为经腹直肠切除术45例(Dixon术40例，Parks术5例)，腹会阴直肠切除术21例。经腹直肠切除术后复发以吻合口为主(37／45，82．2％)，腹会阴直肠切除术后复发则以盆腔或会阴为主(19／21，90．5％)。复发后盆腔放疗中位剂量为40(20—64）Gy，临床症状缓解中位剂量26(10～52)Gy。其中26例在放疗过程中或之后接受过中位7个(2～12)疗程以5-FU为主的化疗。有22例放疗后获补救手术机会。结果：全组中位生存期24个月。Kaplan-Merier法计算生存率，放疗后1、3年总生存率分别为72．2％、17．9％。单因素分析并Log rank检验生存率差异，显示生存率与原发病变的期别、术后复发时间、复发部位及是否加用化疗无关，而仅与是否再次行补救手术有关。放疗后加用补救手术者3年生存期明显较长，为36．0％比8．8％(P=0．016)。结论：直肠癌根治术后局部复发者，放疗具有良好的姑息减症的作用；对部分经腹直肠切除术后的复发病例，放射治疗加补救手术能明显延长生存期。     

Treatment perspectives in locally advanced unresectable pancreatic cancer.

Locally advanced unresectable pancreatic cancer is sometimes encountered without manifest distant metastases. Twenty patients with histologically proven unresectable pancreatic cancer without distant metastases were treated with radiotherapy and 5-fluorouracil (5-FU). Radiotherapy consisted of 50 Gy external upper abdomen radiation in two courses, concomitant with intravenous 5-FU 375 mg/m2 given as a bolus injection 4-6h before radiation on the first 4 days of each treatment course. The treatment protocol was completed in 18 patients without complications. The median survival time was 10 months which compares favourably with a 3-5 months median survival time when treatment is withheld. Nine patients (45 per cent) were alive at 1 year, two patients at 2, 3 and 4 years. A second-look operation was performed in four patients 6, 11, 12 and 22 months after completion of radiotherapy. In two patients the tumour could be resected. It appears that treatment with radiotherapy and 5-FU may benefit patients with locally advanced unresectable pancreatic cancer.     

CT引导下放射性~(125)I粒子组织间植入治疗肺癌

目的探讨CT引导下放射性125I粒子组织间植入治疗肺癌的技术可行性和近期疗效。方法2003年3月~2007年9月,对16例肺癌(12例肺转移癌,4例肺癌术后复发)行CT引导下放射性125I粒子植入治疗。局部麻醉。术前计算机治疗计划系统行三维治疗计划,确定粒子数目、空间分布和粒子针数目。既往放疗肿瘤匹配周边剂量为90~110Gy,未行放疗为140~160Gy。计划靶体积包括临床靶体积加1cm外周。每颗粒子活度为0.40~0.70mCi。中位植入粒子38颗(15~145颗),术后即刻行CT扫描进行质量验证。3例术后1周加三维适形放疗,总剂量45~50Gy。结果中位随访14个月(6~47个月)。无治疗相关严重并发症发生。1年和2年局部控制率分别为93.8%(15/16)和93.8%(15/16)。中位生存时间14个月(6~24个月),1年和2年生存率分别为62.5%(10/16)和37.5%(6/16)。6例死于全身转移,3例死于恶液质和1例死于脑出血。结论CT引导下放射性125I植入治疗复发或转移性肺癌安全,微创,并发症发生率低,疗效肯定,粒子治疗后配合外放疗和全身化疗,有望进一步提高疗效。     

Long-Term Results of Two Prospective Trials of Preoperative External Beam Radiotherapy for Localized Intermediate- or High-Grade Retroperitoneal Soft Tissue Sarcoma

Background The reported data on surgery plus radiotherapy for retroperitoneal soft tissue sarcomas (RPS) have been mostly from retrospective studies. We evaluated the long-term outcome of patients with operable RPS who were treated with protocol-based preoperative radiotherapy followed by complete surgical resection. Methods Data from two prospective trials that included preoperative radiotherapy and surgery for patients with radiographically resectable RPS were combined to define long-term relapse rates and survival. Results Seventy-two patients with intermediate- or high-grade RPS were treated with preoperative radiotherapy (median dose, 45 Gy; range, 18.0–50.4 Gy). Fifty-four patients (75%) had primary RPS, whereas 18 (25%) had recurrent disease. The median tumor size was 15.5 cm. Sixty-four patients completed the planned preoperative radiotherapy; 57 (89%) underwent laparotomy with curative intent, and 54 (95%) had a macroscopically complete (R0 or R1) resection. With a median follow-up of 40.3 months, 28 patients (52%) who received preoperative radiotherapy and underwent a macroscopically complete resection had recurrences. For the 54 patients who underwent R0 or R1 resection after preoperative radiotherapy, the 5-year local recurrence–free, disease-free, and overall survival rates were 60%, 46%, and 61%, respectively. The median overall survival has not been reached (>60 months). Conclusions Patients with intermediate- or high-grade RPS treated with preoperative radiotherapy plus complete resection had a median survival >60 months. This compares favorably to historical data for similar patients treated with surgery alone.     

Locally advanced pancreatic cancer treated with radiation and 5-fluorouracil: a first step to neoadjuvant treatment?

AIM OF THE STUDY: In two institutions, a retrospective analysis was performed on patients with histologically proven locally advanced pancreatic cancer without distant metastases. The aim of this analysis is to assess whether chemoradiotherapy provides survival benefit for patients with locally advanced pancreatic cancer. METHODS: Forty-five patients from the Erasmus Medical Centre (Erasmus MC), Rotterdam, received 5-fluorouracil (5-FU) and radiotherapy and, 38 patients from the Academic Medical Centre Amsterdam (AMC) were offered the best supportive care. Radiotherapy consisted of 50 Gy external upper abdomen radiation in two courses, concomitant with intravenous 5-FU 25 mg/kg/ 24 h continuously on the first 4 days of each treatment course. RESULTS: The treatment protocol was completed in 38 of 45 patients (84%) without complications. Radiological response was evaluated in 38 patients. Ten patients (26%) showed a partial response, stable disease was seen in 6 (16%) patients and progressive disease in 22 (58%) patients. A second-look operation was performed in 8 of 10 patients (72%) showing a radiological response, in 3 patients the tumour could be resected. Median overall survival time for the Erasmus MC group (n = 45) was 9.8 months compared to 7.6 months when the best supportive care was given (AMC group, p = 0.04). CONCLUSION: Although overall survival remains poor, treatment with 5-FU and radiotherapy might benefit some patients with locally advanced pancreatic cancer.     

胃癌同时性肝转移患者不同治疗方法的疗效比较

目的评价不同治疗方案对胃癌同时性肝转移的疗效。方法回顾性分析解放军总医院1998年1月至2012年11月收治的271例胃癌同时性肝转移患者的临床病理资料,其中单纯接受手术治疗者34例（手术组）,单纯接受化疗者103例（化疗组）,接受综合治疗者134例（综合治疗组）。通过随访比较3组接受不同治疗方案患者的预后情况。结果手术组中位生存期为8（3—41）个月,1、3、5年生存率分别为32．4％、2．9％和0;化疗组中位生存期为7（3-50）个月,1、3、5年生存率分别为21．1％、1．1％和0;综合治疗组中位生存期为11（3—84）个月,1、3、5年生存率分别为50．0％、5．0％和O．8％;3组比较,差异有统计学意义（P〈0．05）;手术组与化疗组比较、手术组与综合治疗组比较以及化疗组与综合治疗组比较,差异均有统计学意义（均P〈0．05）。淋巴结转移程度、治疗方式和肝转移灶是否局部处理是影响胃癌同时性肝转移患者生存期的独立预后因素。结论以手术为基础的多学科综合治疗可以改善胃癌同时性肝转移患者的预后。     

External radiotherapy and extrahepatic bile duct cancer.

The hospital records of patients with extrahepatic bile duct cancer who where treated surgically between 1968 and 1983 were reviewed. Of 55 patients, 16 (29%) received radiotherapy after surgery. The total dose given ranged from 40 to 60 Gy. Median follow-up time for analysis was 4.0 months and lasted until January 1988. The overall median survival was 4 months (range 0-36), that of the irradiated patients was 16 months (range 2-36), and that of the 39 patients who were not irradiated was 3 months (range 0-32). When the 13 post operative deaths were excluded the median survival was 4 months. Radiotherapy did not cause any severe complications. No firm conclusion about the role of radiotherapy can be drawn from these data because the patients were not randomly chosen to receive radiotherapy and selection was therefore biased. We conclude that most patients with extrahepatic bile duct cancer still die of locoregional disease. Effective adjuvant treatments are needed and should be evaluated in prospective randomized trials.     

Surgical resection after radiochemotherapy in patients with unresectable adenocarcinoma of the pancreas

BACKGROUND: The use of chemoradiotherapy for pancreatic cancer has been advocated for its potential ability to downstage locally advanced tumors. This article reports our experience with chemoradiotherapy for patients with unresectable, locally advanced pancreatic cancer (superior mesenteric artery or celiac axis encasement). STUDY DESIGN: Since 1998, 61 patients with radiographically unresectable, pathologically confirmed pancreatic adenocarcinoma have received standard fractionation radiation therapy (total dose, 45 Gy at 1.8 Gy, 5 d/wk) with chemotherapy, which included a continuous infusion of fluorouracil (5-FU: 650 mg/m(2)/D1-D5 and D21-D25) and cisplatin (80 mg/m(2)/bolus D2 and D22). Patients with tumor response at restaging CT scan underwent surgical exploration to determine whether the tumor was resectable. RESULTS: Thirty-eight of 61 (62%) restaged patients demonstrated a disease progression. Twenty-three patients (38%) had an objective response, with, in all cases, persistence of arterial encasement. Twenty-three patients underwent exploratory operations after chemoradiotherapy, and 13 underwent standard Whipple resection. So 13 of 23 (56%) patients who had exploratory operation, or 23 of 61 (21%) patients, underwent surgical resection. With a median followup of 27 months, median survival for the resected patients was 28 months. Median survival was 11 months in the nonresponder group (n = 38) and 20 months in the group who received a palliative procedure (n = 10). CONCLUSIONS: Locally advanced, unresectable pancreatic adenocarcinoma may be downstaged by chemoradiotherapy to allow for surgical resection. Patients whose cancer becomes resectable have a median survival at least comparable with survival after resection for initially resectable pancreatic adenocarcinoma.     

Biochemical relapse-free survival in 400 patients treated with I-125 prostate brachytherapy: the Guildford experience

A total of 1200 patients had undergone I-125 prostate brachytherapy (BXT) in our centre. We present prospective outcome data for the first 400 treated patients. Data were analysed from a prospective database of 400 consecutive patients treated with permanent prostate BXT between March 1999 and December 2003. Patients were stratified into low (49%), intermediate (36%) and high (15%) risk as defined by the Memorial Sloan-Kettering Prognostic Index. Patients received 145 Gy BXT alone (41%), BXT with 3 months neoadjuvant androgen deprivation (NAAD) (39%), 45 Gy external beam radiotherapy (EBRT) with 110 Gy BXT (3%) or a combination of NAAD, 45 Gy EBRT and 110 Gy BXT (17%). Biochemical relapse-free survival (bRFS) and prostate-specific antigen (PSA) nadirs were analysed for treatment received in each risk group. Median follow-up was 54 months (range, 38-96 months) with a mean patient age of 63 years. Prostate cancer-specific survival was 99.5%. Twenty-eight patients (7%) experienced biochemical failure according to the 2006 Radiation Therapy Oncology Group-American Society for Therapeutic Radiology and Oncology (RTOG-ASTRO) Phoenix Consensus definition (PSA nadir plus >or=2 ng ml(-1)): nine low-, fourteen intermediate- and five high-risk patients. When stratified by treatment group for low-, intermediate- and high-risk groups, the 5-year actuarial bRFS was 98, 89 and 100% for BXT; 91, 87 and 88% for NAAD and BXT; 100, 80 and 100% for EBRT and BXT; and 100, 92 and 88% for NAAD, EBRT and BXT, respectively. Overall 4- and 5-year PSA 相似文献   

Permanent iodine-125 interstitial radiation therapy in the treatment of non-glioblastoma multiforme high-grade gliomas

BACKGROUND: This study evaluates prognostic factors influencing survival outcomes for 60 patients with permanent iodine-125 implants in the primary treatment of non-glioblastoma multiforme (GBM) high-grade gliomas. METHODS: Stereotactic treatment planning aimed to encompass the contrast-enhancing rim of the tumor visualized by CT, with an initial dose rate of 0.05 Gy/h with 125I, delivering 100 Gy at 1 year and 103.68 Gy at infinity. Survival was evaluated using the Kaplan-Meier method for univariate analysis and the Cox regressional method for multivariate analysis. In addition to the implant, 34 patients received external radiation therapy (5,000-6,000 cGy) before the implant; 13 patients were implanted without additional external beam radiation, and 13 patients underwent external radiation therapy before implant placement. RESULTS: With a mean follow-up of 77.6 months (range 3.5-164 months), 1-, 3-, 5- and 10-year survival were 86.7% (+/-0.05%), 60% (+/-0.07%), 50% (+/-0.07%) and 45.7% (+/-0.7%), respectively. The median survival time was 57 months. Second surgery was performed following the implant in 19 patients. Findings were tumor recurrence in 11 patients (22.5%), radiation necrosis in 7 patients (14.3%) and brain abscess in 1 patient (2%). Age, sex, tumor location, side of brain, tumor volume, Karnofsky score and neurological status were correlated with survival outcome. Favorable prognostic factors were age younger than 45 years, superficial tumor location and preoperative Karnofsky score greater than 70. RPA classification was used to define this group of patients. In RPA classes I and II (n = 43), 1-year survival was 93%, while 3-, 5- and 10-year survival was 67.4, 60.5 and 55.5%, respectively, and median survival time was 91 months. In RPA class III (n = 7), 1-year survival was 71.4%, while 3- and 5-year survival was 42.9 and 28.6%, respectively, and median survival time was 47 months. In RPA class IV (n = 10), 1-year survival was 60%, while 3-, 5- and 10-year survival was 50, 22.2 and 11.1%, respectively, and median survival time was 37 months. CONCLUSION: Brachytherapy with permanent implant of 125I appears promising in the treatment of primary non-GBM malignant gliomas. It improved survival time and reduced the incidence of complications and provided good quality of life. In order to further confirm these results, multicenter randomized prospective studies are needed. RPA analysis is a valid tool to define prognostically distinct survival groups. In this study, 2-year survival and median survival time were improved in all prognostic classes. This would suggest that selection bias alone does not account for the survival benefit seen with 125I implants. Further randomized studies with effective stratification are needed.