Comparison of accelerated hyperfractionated radiotherapy and conventional radiotherapy for supratentorial malignant glioma.
Comparison of accelerated hyperfractionated radiotherapy and conventional radiotherapy for supratentorial malignant glioma.
复制标题
加速超分割放疗与常规放疗治疗幕上恶性胶质瘤的比较。
DOI：
10.1093/jjco/27.1.31
复制
发表时间：
1997
影响因子：
2.4
通讯作者：
M. Abe
中科院分区：
文献类型：
--
作者：
Y. Shibamoto;Y. Nishimura;K. Tsutsui;K. Sasai;M. Takahashi;M. Abe
1988年至1993年，71例胶质母细胞瘤或间变性星形细胞瘤患者接受加速超分割放射治疗（1.5戈伊，每日2次，总剂量为69戈伊，n = 35）或常规分割放射治疗（1.8戈伊，每日1次，总剂量为64.8戈伊，n = 36）。每组中有两名患者没有完成放疗，剩下67名可评价。所有患者在放疗前和放疗后均接受ACNU动脉内（50 mg/m2）或静脉内（100 mg/m2）化疗。在1990年至1992年期间，19名患者在放射治疗期间也接受了静脉注射干扰素-β（3 × 10（6）U，每周三次）。加速超分割组的中位生存期为14.5个月，常规分割组为14个月。加速超分割组的中位进展时间为12个月，常规分割组为9.5个月。加速超分割组和常规分割组之间的生存率（P = 0.89）或无进展生存率（P = 0.25）无显著差异。干扰素治疗与较差的生存率相关。接受加速超分割放疗加干扰素β的10例患者中有4例发生脑坏死，但接受常规分割放疗加干扰素的9例患者中无一例发生脑坏死（P = 0.033）。总之，我们的研究未能证明加速超分割放射治疗恶性胶质瘤的任何可能的好处。加速超分割放射治疗与干扰素β联合应用可能会增加脑坏死的发生率。
Between 1988 and 1993, 71 patients with glioblastoma or anaplastic astrocytoma were treated either with accelerated hyperfractionation radiotherapy (1.5 Gy twice daily to a total dose of 69 Gy, n = 35) or with conventional fractionation radiotherapy (1.8 Gy daily to 64.8 Gy, n = 36). Two patients in each group did not complete radiotherapy, leaving 67 evaluable. All patients received the chemotherapeutic regime ACNU intraarterially (50 mg/m2) or intravenously (100 mg/m2) prior to and after radiotherapy. Between 1990 and 1992, 19 patients also received intravenous interferon-beta (3 x 10(6) U, three times weekly) during radiotherapy. The median survival time was 14.5 months for the accelerated hyperfractionation group and 14 months for the conventional fractionation group. The median time to progression was 12 months for the accelerated hyperfractionation group and 9.5 months for the conventional fractionation group. There was no significant difference in either survival (P = 0.89) or progression-free survival (P = 0.25) between the accelerated hyperfractionation and conventional fractionation groups. Interferon therapy was associated with poorer survival. Brain necrosis developed in four out of 10 patients receiving accelerated hyperfractionation radiotherapy plus interferon-beta, but in none of nine patients receiving conventional fractionation radiotherapy plus interferon (P = 0.033). In conclusion, our study failed to demonstrate any possible benefit of accelerated hyperfractionation radiotherapy for malignant glioma. The incidence of brain necrosis may be increased by combining accelerated hyperfractionation radiotherapy and interferon-beta.