Large dose fraction radiotherapy in the treatment of glioblastoma
Large dose fraction radiotherapy in the treatment of glioblastoma
复制标题
大剂量分次放射治疗胶质母细胞瘤
DOI：
10.1007/bf00165095
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发表时间：
1989
影响因子：
3.9
通讯作者：
H. Niibe
中科院分区：
文献类型：
--
作者：
M. Tamura;Masaru Nakamura;H. Kunimine;N. Ono;A. Zama;K. Hayakawa;H. Niibe
24 名患有多形性胶质母细胞瘤（星形细胞瘤，4 级）的成人接受了直线加速器 X 射线术后大剂量分数放射治疗（LDFR；5 Gy，每周两次）。该组的结果与接受传统分割放疗（CFR；2 Gy，每周 5 次）的 26 名患者的结果进行了比较。两组的时间、剂量和分次 (TDF) 因子均约为 100。 LDFR 和 CFR 后的 1 年生存率分别为 63% 和 65%； 2 年时为 36% vs 8%； 3 年时为 17% vs 4%； 5 年时为 4% 与 0%。尽管 LDFR 的生存曲线优于 CFR，但差异无统计学意义。 9例LDFR患者尸检显示1例无残留肿瘤，13例CFR患者尸检无残留肿瘤；每组有小残留肿瘤3例； 1名LDFR和4名CFR患者肿瘤及周围脑组织广泛凝固性坏死； 3 例 LDFR 和 4 例 CFR 病例中肿瘤增殖；一名 LDFR 和两名 CFR 患者患有混合性胶质母细胞瘤和纤维肉瘤。这些结果表明，与手术加 CFR 相比，最大程度地切除肿瘤并进行 LDFR 可能为胶质母细胞瘤患者提供更好的预后。
Twenty-four adults with glioblastoma multiforme (astrocytoma, grade 4) underwent postoperative large dose fraction radiotherapy (LDFR; 5 Gy twice weekly) with Linac X-rays. The outcome in this group was compared with that of 26 patients who received conventional fractionated radiotherapy (CFR; 2 Gy 5 times weekly). The time, dose, and fractionation (TDF) factor was about 100 in both groups. The survival rates following LDFR and CFR were, respectively, 63% vs 65% at 1 year; 36% vs 8% at 2 years; 17% vs 4% at 3 years; and 4% vs 0% at 5 years. Although the survival curve for LDFR was superior to that for CFR, the difference was not statistically significant. Autopsies of nine LDFR and 13 CFR patients showed no residual tumor in one case and no cases, respectively; small residual tumor in three cases in each group; extensive coagulation necrosis of the tumor and surrounding brain tissue in one LDFR and four CFR patients; tumor proliferation in three LDFR and four CFR cases; and mixed glioblastoma and fibrosarcoma in one LDFR and two CFR patients. These results suggest that maximum tumor removal followed by LDFR may offer a better prognosis for patients with glioblastoma than that offered by surgery plus CFR.