【摘要】 目的采用立体定向放疗与常规放疗结合治疗高分级脑胶质瘤,分析其疗效,探讨其影响预后的因素。方法自1998年12月至2005年1月用立体定向放疗与常规放疗结合的方法治疗高分级脑胶质瘤106例。立体定向放疗针对GTV追加剂量,每次5-7Gy,共计5-7次,常规放疗主要针对亚临床病变,一般剂量为50Gy。寿命表法统计生存率。结果本组病例1、3年生存率分别为 66．20k,和27．0％。Ⅲ级胶质瘤较Ⅳ级的患者预后好,预后与年龄、肿瘤部位和治疗剂量等其他因素无关。结论立体定向放疗加常规放疗治疗高分级脑胶质瘤既发挥了放射物理剂量分布的优点,又符合放射生物学原则,较以往治疗提高了患者的生存机会。更多还原

【Abstract】 Objective To determine the value and prognostic factors of fractionated stereotactic radiotherapy (SRT) given in combination with conventional radiotherapy (CRT) for high - grade gliomas. Methods From December 1998 to January 2005, 106 patients (74 male, 32 female) with high - grade gliomas (68 WHO Ⅲ, 38 WHO Ⅳ) 39.22cm3 in average volume, were treated with a fractionated SRT boost to 25 - 49Gy in 5 - 7 fraction following partial brain CRT to a dose of 50Gy in 25 fractions. SRT boost to gross tumor volume. The aim of CRT was the clinical target volume which was defined as GTV margin plus 2 -3cm. Results Overall survival was 66. 2% at 1 year and 27. 0% at 3 years. Median survival for all patients was 20. 6 months. The side effects included epilepsy in 5 tumors bordering upon the cerebral cortex, partial cerebral edema in 6 cases, which was alleviated after using steroid and anti - epilepsy medicine. The only prognostic factor of high - grade gliomas is pathology. The prognosis was not correlation with age, tumor location, treatment dose and other factors. Conclusions Combined fractionated SRT and CRT in patients with high - grade glioma is feasible. Compared to historical data survival is significantly better with this method in current dose level.更多还原