质子放射治疗颅内肿瘤66例近期疗效分析

背景与目的:颅内肿瘤的放射治疗大多是手术后的辅助治疗,高能质子束有尾部剂量快速降落现象,其物理特性和生物特性均优于光子,颅内肿瘤是质子放射治疗的最佳适应证之一,特别是对部分颅底肿瘤的疗效优于开颅手术,而无手术的风险和并发症。本文通过观察质子放射治疗颅内肿瘤的近期疗效,总结和探讨质子放射治疗颅内肿瘤的剂量、分割方法和疗效。方法:2004年12月至2006年10月,共收治各类脑瘤66例,其中胶质瘤46例,脑膜瘤5例,脊索瘤8例,其他良恶性肿瘤7例。恶性肿瘤总剂量为54～70CGE,单次剂量1.8～3CGE;良性肿瘤总剂量为45～72CGE,单次剂量1.8～5CGE。疗效判断标准为:显效、有效、无效三组。观察时间胶质瘤为9.8个月(1~20个月),良性肿瘤10.5个月(3~22个月)。结果:质子放射治疗66例的总有效率90.9%。胶质瘤显效13例,占27.1%,有效29例,占60.4%,其他恶性肿瘤1例显效,1例死亡。48例恶性肿瘤总有效率89.6%。良性肿瘤显效5例,占27.8%,有效12例,占66.7%,18例良性肿瘤总有效率94.4%。结论:质子因其优越的物理特性,适用于所有需放射治疗的患者,特别是对放疗后复...

Analysis of Short-term Curative Effect of Proton Therapy in 66 Cases of Intracranial Tumors

BACKGROUND & OBJECTIVE: Radiotheraphy is the standard adjuvant therapy to intracranial tumor after surgery. Physically and biologically, proton is better than photon in treatment of intracranial tumor because proton therapy may cause less risk and complications. The advantage could be more substantial when compared with surgical excision of some skull base tumors. This study was designed to observe the initial therapeutic effect, doses and methods of proton therapy in intracranial tumors. METHODS: 66 cases of intracranial tumors were treated by proton therapy from December 2004 to October 2006. These included glioma in 46 cases, meningioma in 5 cases and chordoma in 8 cases. The total dose ranged from 54 CGE to 70 CGE and each fraction dose from 1.8 CGE to 5 CGE in malignant tumor. And dosage was from 45 CGE to 72 CGE and each fraction dose from 1.8 CGE to 5 CGE in benign tumor. RESULTS: The follow-up period for glioma patients range from 1 to 20 months (averaged 9.8 months). Follow-up period for benign tumor were from 3 to 22 months (averaged 10.5 months). The overall response rate was 90.9%. In glioma 13 patients showed disappearance of the tumor (27.1%), 29 cases were partially responding(60.4%). One malignant tumor disappeared. However, there was one mortality. The overall response rate was 89.6% in 48 cases of malignancy tumors. Benign tumors showed disappeared in 5 cases (27.8%)and reduced in 12 cases (66.7%). The overall response rate was 94.4% in benign tumor. CONCLUSIONS: Proton therapy is a effective and safe treatment for intracranial tumors. Compared with radiotherapy, proton therapy showed less radiation-related complications. Patients had a high response rate and low complication rate .The result warrants further study on proton therapy.