【摘要】 目的分析术后三维适形放疗和调强适形放疗对神经胶质瘤的近期疗效和预后因素。方法46例神经胶质瘤给予三维适形放疗或调强适形放疗。根据Kernohan分级,神经胶质瘤Ⅰ、Ⅱ级32例,Ⅲ、Ⅳ级14例。显在肿瘤靶区(GTV)DT60-72Gy/25-30f,临床肿瘤靶区(CTV)DT48.5-60Gy/25-30f,计划肿瘤靶区(PTV)DT46-55Gy/25-30f。采用Kaplan-Meier法进行生存分析,Logrank进行单因素分析,Cox回归模型进行多因素分析。结果全组有效率(CR+PR)37.0%(5+12/46),1、2年生存率93.0%和81.0%。单因素和多因素分析显示外科切除程度、放射剂量、病理分级是影响疗效的预后因素。结论三维适形放疗和调强适形放疗是治疗神经胶质瘤的有效方法,外科切除程度、放射剂量、病理分级是影响疗效的预后因素,神经胶质瘤术后三维适形和调强适形放疗的远期疗效仍有待于观察。更多还原

【Abstract】 Objective To analyze the short term clinical result prognosis of postoperative 3 dimensional conformal radiotherapy(3D-CRT) and intensity modulated radiotherapy(IMRT) for 46 cases with gliomas.Methods 46 cases with gliomas received postoperative 3D-CRT or IMRT from Aug 2004 to Jul 2007,according to the Kernohan histological classification of brain gliomas,32 cases in grade Ⅰ,Ⅱ,14 cases in grade Ⅲ,Ⅳ.The extent of surgical resection were divided into total resection,subtotal resection and biopsy.23 cases in total resection,19 cases in subtotal resection,4 cases in biopsy.The prescription dose was DT 60-72 Gy/25-30 f to gross tumor target volume(GTV),DT 48.5-60 Gy/25-30 f to clinical tumor target volume(CTV),DT 45-55 Gy/25-30 f to planned tumor target volume(PTV).Kaplan-Meier method was used to calculated the over survival rate,Logrank test for univariate analysis,Cox proportional hazard model in multivariate analysis.Results The respone rate(CR+PR) was 37.0%(5+12/46),1,2 year survival rates were 93.0%,81.0%,respectively,the univariate and multivariate analysis showed extent of surgical resection,prescriptional dose and histological classification were poor prognostical factors.Conclusions The 3 dimensional conformal radiotherapy(3D-CRT) and intensity modulated radiotherapy(IMRT) are the effective treatment in the patients with gliomas,the extent of surgical resection,prescriptional dose and histological classification were poor prognostical factors,the remote survival is needed to investgate.更多还原