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目的探讨高剂量放射合并化学药物对脑恶性肿瘤和脑正常组织的综合生物效应。方法1例27岁脑左额叶星形细胞瘤术后残留的患者,自愿接受高剂量放射治疗80 Gy(生物效应剂量96.67 Gy);尼莫司汀125~150 mg,8个周期。历经3次脑手术,3次术后组织病理研究,动态临床医学观察40个月。结果①未发现急性脑放射剂量限制性毒性;②有轻度放化疗脑损伤(小灶性);③患者3.5年无瘤生存,未见肿瘤复发;④无相关的临床表现及相关的神经定位体征。结论青壮年脑左额叶组织可能有较高的放射耐受性。相对于肿瘤而言,小灶性的损伤是可以接受的。提示对于脑恶性肿瘤还有放射剂量提升的空间,以进一步提高疗效。
Objective To investigate the comprehensive biological effects of high-dose radiation combined with chemicals on brain malignant tumors and normal brain tissues. Methods One patient, 27 years old, with left frontal lobe astrocytoma who had residual disease was volunteered to receive 80 Gy of high dose radiation (96.67 Gy for biological effect) and 125 to 150 mg of nimustine for 8 cycles. After 3 brain surgeries, 3 postoperative histopathological studies and dynamic clinical observation for 40 months. Results ① No acute radiation-limited dose-limiting toxicity was found; ② mild chemoradiotherapy brain injury (focal); ③3.5-year disease-free survival and no tumor recurrence; ④non-related clinical manifestations and related neurological location signs . Conclusion Young patients with left frontal lobe may have higher radiation tolerance. Relative to the tumor, the focal lesion is acceptable. Tip for brain malignant tumors there is room for radiation dose to further improve the efficacy.