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目的:探索立体定向三维适形放射治疗脑胶质瘤的疗效和放射反应。方法:30例脑胶质瘤患者,其中术后残留者21例,术后复发者5例,放疗后复发者4例。利用CT模拟定位及三维重建,通过三维适形放射治疗系统,设放射野5~7个,采用圆形限光筒同中心非共面照射7例,多叶光栏或挡铅技术照射23例。取包绕靶区(PTV)90%的等剂量曲线计算,PTV边缘剂量每次6Gy,隔日1次,每周3次,共7次,总剂量42Gy,相当于常规分割照射等效生物效应剂量(BED)56Gy/28F。结果:放射治疗后1~3个月内,根据MRI或MRI+CT复查;CR12例(40.0%),PR10例(33.3%),NC6例(20.0%),PD2例(6.7%)。有效率(CR+PR)为73.3%。0.5、1、2、3年总生存率分别为93.3%,77.8%,71.31和53.18%。副反应除个别有轻度恶心,头昏外均未见其他严重副反应。结论:立体定向三维适形放射治疗脑胶质瘤是一种安全有效的方法,副反应小,能为大多数患者所耐受,有较好的近期疗效;远期疗效和后期放射损伤有待进一步观察。
Objective: To explore the efficacy and radiation response of stereotactic three-dimensional conformal radiotherapy for glioma. Methods: Thirty patients with glioma were recruited. Among them, 21 were residual after operation, 5 were recurred after operation, and 4 were recurred after radiotherapy. Using CT virtual positioning and three-dimensional reconstruction, three to five-dimensional conformal radiotherapy system was set up. Radiation fields were set at 5-7 radiographs. Seventeen cases were treated by non-coplanar circular toric light tube and 23 cases by multi-leaf light bar or lead-block technique . Take the 90% of the target volume (PTV) isodose curve calculation, PTV marginal dose of 6Gy, every other day, 3 times a week, a total of 7 times, a total dose of 42Gy, equivalent to the conventional fractionation irradiation equivalent biological effect dose (BED) 56Gy / 28F. Results: According to MRI or MRI + CT, radiotherapy was performed in 1 to 3 months after radiotherapy. CR 12 cases (40.0%), PR 10 cases (33.3%), NC 6 cases (20.0%) and PD 2 cases (6.7%). The effective rate (CR + PR) was 73.3%. The overall survival rates at 0, 5, 1, 2 and 3 years were 93.3%, 77.8%, 71.31 and 53.18%, respectively. Side effects except mild nausea, dizziness and no other serious side effects. Conclusion: Stereotactic three-dimensional conformal radiotherapy of glioma is a safe and effective method, with fewer side effects and tolerability in most patients with better short-term curative effect. Long-term curative effect and late radiation injury need further Observed.