| 常规加IMRT推量放疗联合化疗治疗高分级胶质瘤的疗效和预后因素 |
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| 作者单位： | Department of Radiation Oncology of Shanghai Gamma-knife Hospital,Brain Tumor Center of Huashan Hospital, Fudan University,Shanghai 200235,China |
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| 摘 要： |
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| 收稿时间： | 2007-02-28 |
Conventional radiotherapy followed by IMRT as a boost in combination with chemotherapy treatment for high-grade gliomas: prognostic factors and outcomes |
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| Yang Wang,Xiaofang Sheng,Li Pan,Jin Gao,Shu Chen,Wei Dong,Lei Sun,Jiazhong Dai. Conventional radiotherapy followed by IMRT as a boost in combination with chemotherapy treatment for high-grade gliomas: prognostic factors and outcomes[J]. The Chinese-German Journal of Clinical Oncology, 2010, 9(6): 337-343. DOI: 10.1007/s10330-010-0623-4 |
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| Authors: | Yang Wang Xiaofang Sheng Li Pan Jin Gao Shu Chen Wei Dong Lei Sun Jiazhong Dai |
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| Affiliation: | (1) Department of Radiation Oncology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA;(2) Graduate Division of Radiological Sciences, Department of Radiology, The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA;(3) Department of Radiation Medicine, Oregon Health &; Science University, Portland, OR, USA;(4) Department of Radio-Oncology, University of Innsbruck, Innsbruck, Austria;(5) Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, TX, USA;(6) Department of Radiation Oncology, University of Utah Health Sciences Center, Salt Lake City, UT, USA |
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| Abstract: | Objective:The aim of the study was to retrospectively evaluate the outcomes and important prognostic factors for patients with high-grade gliomas(HGG)treated with conventionalradiotherapy(RT)followed by IMRT as a boost in combination with chemotherapy.Methods:From November 2004 to November 2006,112 consecutive patients with high-grade gliomas were treated with radiotherapy,which included initial conventional radiotherapy and an IMRT boost to a total dose of 57.5-62.5 Gy,with 27-29 fractions delivered over 37-45 days.All cases received 3-6 cycles of chemotherapy,63 cases received temozolomide,and another 49 cases received methyl-CCNU and teniposide.The acute and late treatment toxicities and the patterns of treatment failure were recorded.The overall survival(OS)rate and progression-free survival(PFS)rate were calculated,and the prognostic factors were analyzed.Results:Most of the acute radiation reactions were grade 1 or 2.No grade 4 acute reactions were noted.Three cases developed radiation necrosis.Grades Ⅰ,Ⅱ,and Ⅲ myelosuppressions were observed in 5,32,and 12 cases of 49 patients treated with teniposide and methyl-CCNU,respectively.Grades Ⅰ and Ⅱmyelosuppressions were observed in 15 and 3 of the 63 patients who were treated with temozolomide,respectively.The 57 cases(50.9%)had recurred locally,and 13 cases(11.6%)had intracranial dissemination.The OS rates at 1,2,and 3 years were 78.9%,54.7%,and 30.8%,respectively.The PFS rates at 1,2,and 3 years were 63.8%,38.9%,and 10.5%,respectively.A multivariate analysis showed that only tumor location and KPS were prognostic factors of OS.These same two variables and histopathology were statistically significant predictive factors in a multivariate analysis for PFS.Conclusion:Radiation toxicities were not found to be increased in this retrospective study with 112 consecutive patients of combined modality therapy including an IMRT boost treatment for HGG.Higher rate of local regional dissemination within the brain was observed than before.Tumor location,histopathology and KPS were important prognostic factors. |
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| Keywords: | glioma radiotherapy(RT) prognostic factor |
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