CAJ | 학술논문

目的:评价星形胶质细胞瘤的不同分割剂量调强放射治疗(IMRT)疗效和副作用.方法:2001年10月至2006年12月,58例经病理证实的星形胶质细胞瘤接受了IMRT治疗.根据世界卫生组织(WHO)分类,其中Ⅱ级32例,Ⅲ级20例,Ⅳ级(胶质母细胞瘤)6例.58例中大分割IMRT治疗32例(包括Ⅳ级3例、Ⅲ级11例、年龄大于40岁的Ⅱ级18例);常规分割IMRT治疗26例.结果:1、3和5年总生存率(OS)分别为86%、52%和45%,1、3和5年无进展生存率(PFS)分别为77%、38%和25%.分层分析显示WHOⅡ级患者大分割组疗效优于常规分割组,两组OS和PFS差异有统计学意义(p=0.049和P=0.006);WHOⅢ级患者大分割组的OS和PFS高于常规分割组,但差异无统计学意义.只有1例患者出现了晚期RTOG 3级神经毒性.结论:与常规分割IMRT相比,大分割IMRT有可能提高星形细胞瘤的总生存率和无进展生存率.
목적:평개성형효질세포류적불동분할제량조강방사치료(IMRT)료효화부작용.방법:2001년10월지2006년12월,58례경병리증실적성형효질세포류접수료IMRT치료.근거세계위생조직(WHO)분류,기중Ⅱ급32례,Ⅲ급20례,Ⅳ급(효질모세포류)6례.58례중대분할IMRT치료32례(포괄Ⅳ급3례、Ⅲ급11례、년령대우40세적Ⅱ급18례);상규분할IMRT치료26례.결과:1、3화5년총생존솔(OS)분별위86%、52%화45%,1、3화5년무진전생존솔(PFS)분별위77%、38%화25%.분층분석현시WHOⅡ급환자대분할조료효우우상규분할조,량조OS화PFS차이유통계학의의(p=0.049화P=0.006);WHOⅢ급환자대분할조적OS화PFS고우상규분할조,단차이무통계학의의.지유1례환자출현료만기RTOG 3급신경독성.결론:여상규분할IMRT상비,대분할IMRT유가능제고성형세포류적총생존솔화무진전생존솔.
Objective:To investigate the outcome and adverse effects of IMRT with different dose fractionations for as-trocytic tumors.Methods:From October 2001 to December 2006,58 patients with astrocytic tumor were treated with IMRT in our hospital.According to the World Health Organization (WHO) classification,there were 32 grade Ⅱ cases,20 grade Ⅲ cases and 6 grade Ⅳ cases(glioblastoma multiforme,GBM).Thirty-two of 58 patients(3 grade Ⅳ cases,11 grade Ⅲ cas-es and 18 grade Ⅱ cases older than 40 years were treated with hypofractionated IMRT,26 patients were treated with standard fractionation IMRT.Results:The 1-,3- and 5-year overall survival (OS) rates were 86%,52% and 45% respective-ly.The 1-,3- and 5-year progression-free survival (PFS) rates were 77%,38% and 25%,respectively.Patients of gradeⅡ treated with hypofractionated IMRT had better OS and PFS(P=0.049 and P=0.006).Patients of grade Ⅲ treated with hypo-fractionated IMRT had a better OS and PFS,but was not statistically significant(P>0.05).One patient experienced Radia-tion Therapy Oncology Group (RTOG) grade Ⅲ late neurotoxicity.Conclusion:Compared with standard fractionation IMRT,hypofractionated IMRT is helpful for prolonging the survival of patients with astrocytoma.