恶性脑胶质瘤立体定向加常规放疗的疗效观察(附32例临床分析)

目的探讨病理高级别胶质瘤术后,常规外照射加立体定向照射放疗推量治疗模式的疗效。方法对病理诊断均为WHOⅢ～Ⅳ级胶质瘤治疗后患者,放射治疗前程常规照射和后程立体定向照射推量相结合的方式,外照射46～50Gy23～25f/4.6～5W后,紧接着用分次立体定向照射推量14～20Gy。结果治疗后近期效果满意,无严重神经功能障碍并发症。本组病例1、2、3年总体生存率分别为77.3%、52.5%、25.0%;1、2、3年无进展生存率分别为59.8%、36.7%、16.3%。急性放射反应多为1～2级,没有发现4级以上急性放射反应。结论采用分次立体定向加常规放疗治疗胶质瘤既发挥了放射物理剂量分布的优点,又符合放射生物学原则,是控制高分级胶质瘤生长及延迟复发的重要辅助治疗手段。

High grade glioma stereotactic radiotherapy and regular clinical observation

Objective Of high-grade glioma after surgery,conventional external beam radiotherapy plus stereotactic irradiation to push the amount of the efficacy of treatment modalities.Methods On the pathological diagnosis of WHO Ⅲ ~ Ⅳ grade glioma after treatment,radiation therapy and post-irradiation processes future conventional stereotactic external irradiation 46~50 Gy23~25f/4.6~5W after,followed by fractionated stereotactic radiation to push the amount of 14~20Gy.Results Satisfactory short-term effect after treatment,no severe neurological dysfunction complications.The patients and 3-year overall survival rates were 77.3%,52.5%,25.0%;3-year progression-free survival rates were 59.8%,36.7%,16.3%.Acute radiation reactions more than 1 to 2,did not find four more acute radiation reaction.Conclusion The use of fractionated stereotactic radiotherapy plus conventional radiation therapy has played a glioma both physical dose distribution advantages,and consistent with the principles of radiation biology,is to control the growth of high-grade glioma recurrence and delay important adjuvant treatment.