30例脑胶质瘤的术后调强适形放射治疗

魏 瑞; 张阳德; 何剪太; 戴幼艺

doi:10.3971/j.issn.1000-8578.2010.04.023

30例脑胶质瘤的术后调强适形放射治疗

Postoperative Intensity Modulated Radiation Therapy for 30 Cases with Malignant Gliomas

摘要

摘要: 目的探讨术后脑胶质瘤调强适形放疗的临床疗效。方法 30例脑胶质瘤予术后调强适形放疗，以90%~95%等剂量线包绕计划靶体积（PTV）。肿瘤靶体积（GTV）照射(58~70) Gy/(28~33)f，临床靶体积（CTV）照射(56~66) Gy/(28~33)f ，PTV照射 (50.4~60) Gy/(28~33)f，1次/天，5f/w。结果完全缓解率（CR）23.3%（7/30），部分缓解率（PR）66.7%（20/30），稳定率为10%（3/30）。1、2、3年总生存率分别为93.3%、76.7%、60%。Ⅰ~Ⅱ级1、2、3年生存率分别为100%、94.1%、76.5%；Ⅲ~Ⅳ级1、2、3年生存率分别为84.6%、53.8%、38.5%。Ⅰ~Ⅱ级组与Ⅲ~Ⅳ级组相比差异有统计学意义（P=0.0153）。患者对治疗的耐受性良好，不良反应主要为颅高压症状，放射性脑水肿。结论脑胶质瘤术后调强适形放疗疗效好，无严重不良反应。

Abstract: Objective To analyze the outcome of intensity modulated radiation therapy(IMRT). Methods Thirty patients with malignant gliomas were received postoperative intensity modulated radiation therapy,the 90%~95% isodose curve include planning target volume(PTV).The prescription dose was (58~70) Gy/(28~33) f to GTV(gross target volume),(56~66) Gy/(28~33) f to CTV (clinical target volume)，(50.4~60) Gy/(28~33) f to PTV，1 f/d，5 f/w. Results The complete response (CR) rate was 23.3%（7/30）,the partial response (PR) was 66.7%（20/30）,stable disease(SD) was 10%（3/30）.The 1-year,2-year and 3-year survival rates were 93.3%,76.7%,60% respectively.The 1-year,2-year and 3-year survival rates were 100%,94.1%,76.5% for grade Ⅰ~Ⅱ,and 84.6%,53.8%,38.5% for grade Ⅲ~Ⅳ respectively.There was significant difference (P=0.0153).All patients showed well toleration in this treatment scheme.The main side effects were intracranial hypertension,cerebral edema. Conclusion IMRT is an effective and safe treatment in the patients with malignant gliomas.

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