脑瘤术后放疗辅助高压氧治疗的临床观察

目的探讨高压氧（HBO）在术后放疗中的临床价值及对预后的影响。方法自2003年2月—2006年1月,对60例脑瘤术后患者进行前瞻性随机分组对比研究,单纯放疗组（R组）及放疗加高压氧组（HBO＋R组）各30例。所有患者均在术后2～4周开始常规放疗,采用6MV-X线照射40Gy;4周后缩为局部野照射20Gy/2周。HBO＋R组在每次HBO治疗后15～30min内给予放疗。结果 HBO＋R组和R组的总有效率分别为86.7%和56.7%,两组差异有统计学意义（P〈0.05）;两组中位TTP差异也有统计学意义（P〈0.01）;1、2、3年生存率分别为93.3%、80.0%、60.0%和86.7%、50.0%、33.3%,HBO＋R组略优。不良反应发生率HBO＋R组低于R组。结论高压氧联合放疗对脑瘤术后患者可提高局部控制率、改善中位生存期、减轻不良反应。

Clinical study on postoperative radiotherapy combined with hyperbaric oxygenation on malignant brain tumors

Objective To analyze the clinical outcomes of brain malignant tumors treated with postoperative radiotherapy（R）and hyperbaric oxygenation（HBO）,compared with postoperative radiotherapy alone.Methods From February 2003 to January 2006,60 postoperative brain malignant tumor patients were randomized into Group HBO＋R（n=30）and Group R（n=30）.All the patients received radical R in 2-4 weeks after operation.Total brain irradiation of 40 Gy was administered over 4 weeks with 6MV-X rays and then,a local boost of 20 Gy over 2 weeks was supplemented with cone-down portals.In Group HBO＋R,R was given within 15-30 minutes after HBO therapy.Results The total effective rate was 86.7% Group HBO＋R and 56.7% in Group R,between which the deference was significant（P〈0.05）.Median time to tumor progression（TTP）was longer in Group HBO＋R（P〈0.01）.The 1-,2-and 3-year survival rates were 93.3%,80.0% and 60.0% in Group HBO＋R,and 86.7%,50.0% and 33.3% in Group R,respectively.Group HBO＋R had a higher survival rate.The adverse reaction rate was lower in Group HBO＋R than in Group R.Conclusion Radiation combined with HBO is evidently able to improve the clinical effect and the survival rates for patients with postoperative brain malignant tumors,and it can also reduce the adverse reaction rate on radiotherapy.