伽玛刀分次治疗脑胶质瘤的临床研究

目的探讨大分割分次伽玛刀治疗脑胶质细胞瘤的疗效及并发症。方法 2005年1月～2010年1月以修正GTV规划,采用伽玛刀大剂量分次治疗脑胶质细胞瘤145例,单次6～11Gy,2～3次完成。结果 89.3%临床症状得到改善,有效率（CR＋PR＋50%NC）为65.5%（95/145）,1、2、3年生存率分别为85.8%（97/113）、88.9%（72/81）和78.3%（36/46）,HGG3年生存率达70.6%（12/17）,远期生存明显改善。结论采用伽玛刀的放射物理剂量分布优势实现大剂量分割,能有效杀灭脑胶质细胞瘤的放射抵抗克隆,并能较好地保护正常脑组织,有望提高脑胶质细胞瘤患者的生存率和生活质量。

A clinical study of fractionated gamma knife radiosurgery in patients with glomas

Objective To study the value and the side efects of fractionated gamma knife radiosurgery given in patients with gliomas.Methods From January 2005 to January 2010,145 patients with gliomas were treated with a fractionated gamma knife radiosurgery boost with 6~11Gy fraction dose to 50Gy in 2~3 fractions.The clinical target volume which was,defined as GTV margin plus 1cm.Results Overall survival was 85.8% at 1 year,88.9% at 2 year and 78.3% at 3 years.Median survival was improved.Conclusion Fractionated gamma knife radiosurgery delivered a adequate therapeutic radiation dose to the target volume,could destroy the radiation resistance clones of gliomas celis and should avoid further dose to the nomal tissues,had less side efects and could be well tolerated.It was encouraging in these patients with survival and quality of life.Further work is underway to study more patients and to investigate tumour control probability and dose escalation.