58例胶质瘤不同分割剂量调强放疗疗效观察*

Effect of Intensity-modulated Radiotherapy with Different Dose Fractionations on Astrocytic Tumors

    摘要
  • 摘要: 目的：评价星形胶质细胞瘤的不同分割剂量调强放射治疗（IMRT）疗效和副作用。方法：2001年10月至2006年12月，58例经病理证实的星形胶质细胞瘤接受了IMRT 治疗。根据世界卫生组织（WHO）分类，其中Ⅱ级32例，Ⅲ级20例，Ⅳ级（胶质母细胞瘤）6 例。58例中大分割IMRT 治疗32例（包括Ⅳ级3 例、Ⅲ级11例、年龄大于40岁的Ⅱ级18例）；常规分割IMRT 治疗26例。结果：1、3 和5 年总生存率（OS）分别为86% 、52% 和45% ，1、3 和5 年无进展生存率（PFS）分别为77% 、38% 和25% 。分层分析显示WHOⅡ级患者大分割组疗效优于常规分割组，两组OS和PFS 差异有统计学意义（P=0.049 和P=0.006）；WHOⅢ级患者大分割组的OS和PFS 高于常规分割组，但差异无统计学意义。只有1 例患者出现了晚期RTOG 3 级神经毒性。结论：与常规分割IMRT 相比，大分割IMRT 有可能提高星形细胞瘤的总生存率和无进展生存率。

     

    Abstract: Objective:To investigate the outcome and adverse effects of IMRT with different dose fractionations for as -trocytic tumors. Methods:From October2001to December 2006, 58patients with astrocytic tumor were treated with IMRT in our hospital. According to the World Health Organization (WHO) classification, there were 32grade Ⅱcases, 20grade Ⅲ cases and 6 grade Ⅳcases (glioblastoma multiforme, GBM). Thirty-two of 58patients (3 grade Ⅳcases, 11grade  cas -es and18grade Ⅱcases older than 40years) were treated with hypofractionated IMRT, 26patients were treated with standard fractionation IMRT. Results: The 1-, 3- and 5-year overall survival (OS) rates were 86%,52% and 45% respective-ly. The 1-, 3- and 5-year progression-free survival (PFS) rates were 77%,38% and 25%, respectively. Patients of grade Ⅱ treated with hypofractionated IMRT had better OS and PFS ( P=0.049 and P=0.006 ). Patients of gradeⅢtreated with hypo -fractionated IMRT had a better OS and PFS, but was not statistically significant ( P>0.05). One patient experienced Radia -tion Therapy Oncology Group (RTOG) grade Ⅲlate neurotoxicity. Conclusion:Compared with standard fractionation IMRT, hypofractionated IMRT is helpful for prolonging the survival of patients with astrocytoma.

     

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