胶质母细胞瘤同期推量IMRT安全性分析

目的 评价同期推量IMRT技术治疗胶质母细胞瘤的安全性。方法 回顾分析天津市环湖医院2013—2014年接受同期推量IMRT的恶性胶质瘤患者共 46例,观察疗后生存获益及神经不良反应。Kaplan-Meier法生存分析,Cox模型多因素预后分析。结果 全组患者均顺利完成治疗。随访率100%,1年OS率73%,1年PFS 为39%。多因素分析提示联合替莫唑胺同期放化疗是影响生存因素(P=0.016)。16例出现肿瘤进展,其中局部复发 9例、远处播散 7例。结论 同期推量IMRT对胶质母细胞瘤患者的治疗安全有效,但鉴于例数偏少且随访时间较短值得进一步探索。

Safety analysis of Intensity-modulated radiation therapy of glioblastoma with simultaneous integrated boost technique

Objective To investigate clinical efficacy of simultaneous integrate boost for glioblastoma with intensity-modulated radiotherapy (SIB-IMRT). Methods A total of 46 patients with glioblastoma who underwents SIB-IMRT from January 2013 to August 2014,were retrospectively analyzed. Toxicity after completion of SIB-IMRT were assessed. Kaplan-Meier method was used to analyze survival and progression-free survival. Multivariate analyses were performed to determine significant prognostic factors. Results There was no patients delayed by more than grade 3 radiation toxicity. The median overall survival and 1-year survival rates was 69 weeks and 73%,respectively. The progression free survival and 1-year progression-free survival rate were 43 weeks and 39%,respectively. The pattern of failure was identical (9 Local, 7 distant and 0 marginal recurrence). Multivariate analyses show that temozolomide concurrent chemoradiotherapy were independent factors correlated to prognosis. Conclusions The preliminary results demonstrate that SIB-IMRT for glioblastoma appear to be effective and safe. With the limted number of patients in this group,SIB-IMRT could be used for treating glioblastoma with caution,which deserves further study.