OUTCOME AND PATTERNS OF FAILURE FOLLOWING LIMITED-VOLUME IRRADIATION FOR MALIGNANT ASTROCYTOMAS
OUTCOME AND PATTERNS OF FAILURE FOLLOWING LIMITED-VOLUME IRRADIATION FOR MALIGNANT ASTROCYTOMAS
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DOI：
10.1016/0167-8140(91)90143-5
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发表时间：
1991-02-01
影响因子：
5.7
通讯作者：
LEE, YY
中科院分区：
文献类型：
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作者：
GARDEN, AS;MAOR, MH;LEE, YY
1982年1月至1986年6月，连续60例高级别星形细胞瘤患者[39例多形性胶质母细胞瘤（GBM），21例间变性星形细胞瘤（AA）]在活检（13例）或切除（47例）后接受放射治疗。 53名患者接受了有限体积照射，7名患者接受了全脑照射。 平均肿瘤剂量为65.4戈伊。 在35名患者中，化疗作为其初始治疗的一部分。 GBM患者的1年和2年生存率分别为40%和14%。 AA患者的1年和2年生存率分别为76%和52%。 GBM患者1年时的无进展率为13%，AA患者为29%。 48例接受有限体积照射的患者中有34例在放射后CT扫描中有进展的证据。 6例患者（3例GMB，3例AA）在CT扫描中有新的颅内转移部位的证据。 在三名患者中，转移是在先前照射的体积内，在其他三名患者中，它是在该体积之外。 所有6例患者在发现转移部位之前，CT扫描显示原发肿瘤在原始位置进展。 21例患者（15例GBM，6例AA）因复发性肿块至少接受了一次放疗后再手术。 19例患者在原发部位有复发肿瘤，2例患者有坏死但无肿瘤。 高级别星形细胞瘤接受有限体积放射治疗的患者与以前接受全脑放射治疗的患者获得了相同的生存结果。 新的颅内转移不影响结局，因为这些转移总是先于原发部位的肿瘤进展。
Between January 1982 and June 1986, 60 consecutive patients with high-grade astrocytomas [39 glioblastoma multiforme (GBM), 21 anaplastic astrocytoma (AA)] were treated with radiation therapy after biopsy (13 patients) or resection (47 patients). Fifty-three patients were treated with limited-volume irradiation, and seven patients received whole-brain irradiation. The mean tumor dose was 65.4 Gy. In 35 patients, chemotherapy was given as part of their initial treatment. The 1- and 2-year survivals for GBM patients were 40 and 14%, respectively. Survival figures for AA patients were 76 and 52% at 1 and 2 years, respectively. The progression-free rate at 1 year was 13% in GBM and 29% in AA patients. Thirty-four of 48 patients who received limited-volume irradiation had evidence of progression on postirradiation CT scans. Six patients (3 GMB, 3 AA) had evidence of a new intracranial metastatic site on CT scan. In three patients the mestastasis was within the previously irradiated volume, and in the other three patients, it was outside this volume. All six had evidence of progression of their primary tumor at the original location on CT scan prior to the discovery of the mestastatic site. Twenty-one patients (15 GBM, 6 AA) had at least one postirradiation reoperation for a recurrent mass. Nineteen patients had recurrent tumors in the primary site, and two patients had necrosis but no tumor. Patients who received limited-volume irradiation for high-grade astrocytomas achieved the same survival results as patients treated previously with whole brain irradiation. New intracranial metastases did not influence the outcome, since these were always antedated by tumor progression at the primary site.