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389例脑胶质瘤立体定向放射治疗效果评价
引用本文:牛道立,何中,胡慧玲.389例脑胶质瘤立体定向放射治疗效果评价[J].中德临床肿瘤学杂志,2005,4(4):221-224.
作者姓名:牛道立  何中  胡慧玲
作者单位:[1]Department of Radiation Oncology, The First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120, China [2]Department of Neurosurgery, The First Affiliated Hospital of Henan Science and Technology University, Luoyang 471000,China [3]Center of X-Knife, The First Affiliated Hospital of Henan Science and Technology University, Luoyang 471000, China
摘    要:Objective: To investigate the treatment effectiveness and side effects of stereotactic radiotherapy for brain glioma. Methods: From Jun. 1995 to Dec. 1998, 389 cases of brain gliomas were treated by stereotactic radiotherapy, among which 151 cases were treated by stereotactic radiosurgery (SRS) and the other 238 cases, by fractionated stereotactic radiotherapy (FSRT). In the SRS group, the marginal tumor dose was 20 to 30 Gy (median, 2.6 Gy). One to 6 isocenters (median, 2.48) and 5 to 21 irradiation arcs (median, 8.45) were applied. In the FSRT group, the per-fraction marginal tumor dose was 8 to 12 Gy with 1 to 6 isocenters (median, 2.53), 6 to 20 irradiation arcs (median, 8.25) and 2-5 fractions delivered everyday or every other day. Results: Three months after treatment, the complete and partial response rates were 13.9% and 45.7% in SRS group respectively. The stable disease rate was 17.2%. The total effective rate was 76.8%. In FSRT group, the complete and partial remission rates were 19.7% and 47.9% respectively. The stable disease rate was 20.6%. The total effective rate was 88.2%. The total effective rate of FSRT group was higher than that in SRS group (X^2=9.874, P=0.020). The 1-year, 3-year and 5-year survival rate of all patients was 54.3%, 29.3%, 16.5% respectively. The 1-year, 3-year and 5-year survival rate in SRS group and FSRT group was 52.3% vs 26.5%, 11.9% vs 55.5%, and 31.1 vs 19.3% respectively. There was no significant difference between the two groups (X^2=2.16, P=0.1417). The brain edema caused by the main radiation was more severe in the SRS group than in FSRT group (X^2=4.916, P=0.027). Conclusion: It is effective for brain glioma to be treated by stereotactic radiotherapy. Compared with SRS, the FSRT has the advantage of good effect and less side response.

关 键 词:分次立体定向放射治疗  立体定向放射外科  脑胶质瘤  预后
收稿时间:2004-11-09
修稿时间:2005-06-03

Therapeutic Effects of Stereotactic Radiotherapy on 389 Cases of Brain Glioma
Daoli NIU,Zhong HE,Huiling HU.Therapeutic Effects of Stereotactic Radiotherapy on 389 Cases of Brain Glioma[J].The Chinese-German Journal of Clinical Oncology,2005,4(4):221-224.
Authors:Daoli NIU  Zhong HE  Huiling HU
Institution:(1) Department of Radiation Oncology, The First Affiliated Hospital of Guangzhou Medical College, 510120 Guangzhou, China;(2) Department of Neurosurgery, The First Affiliated Hospital of Henan Science and Technology University, 471000 Luoyang, China;(3) Center of X-Knife, The First Affiliated Hospital of Henan Science and Technology University, 471000 Luoyang, China
Abstract:Objective: To investigate the treatment effectiveness and side effects of stereotactic radiotherapy for brain glioma. Methods: From Jun. 1995 to Dec. 1998, 389 cases of brain gliomas were treated by stereotactic radiotherapy, among which 151 cases were treated by stereotactic radiosurgery (SRS) and the other 238 cases, by fractionated stereotactic radiotherapy (FSRT). In the SRS group, the marginal tumor dose was 20 to 30 Gy (median, 2.6 Gy). One to 6 isocenters (median, 2.48) and 5 to 21 irradiation arcs (median, 8.45) were applied. In the FSRT group, the per-fraction marginal tumor dose was 8 to 12 Gy with 1 to 6 isocenters (median, 2.53), 6 to 20 irradiation arcs (median, 8.25) and 2-5 fractions delivered everyday or every other day. Results: Three months after treatment, the complete and partial response rates were 13.9% and 45.7% in SRS group respectively. The stable disease rate was 17.2%. The total effective rate was 76.8%. In FSRT group, the complete and partial remission rates were 19.7% and 47.9% respectively. The stable disease rate was 20.6%. The total effective rate was 88.2%. The total effective rate of FSRT group was higher than that in SRS group (χ2=9.874, P=0.020). The 1-year, 3-year and 5-year survival rate of all patients was 54.3%, 29.3%, 16.5% respectively. The 1-year, 3-year and 5-year survival rate in SRS group and FSRT group was 52.3% vs 26.5%, 11.9% vs 55.5%, and 31.1 vs 19.3% respectively. There was no significant difference between the two groups (χ2=2.16, P=0.1417). The brain edema caused by the main radiation was more severe in the SRS group than in FSRT group (χ2=4.916, P=0.027). Conclusion: It is effective for brain glioma to be treated by stereotactic radiotherapy. Compared with SRS, the FSRT has the advantage of good effect and less side response.
Keywords:fractionated stereotactic radiotherapy  stereotactic radiosurgery  brain glioma  prognosis
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