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目的 探讨X线立体定向放射治疗在脑恶性胶质细胞瘤 (BMG)治疗中的作用。方法 1996年 10月～ 1998年 10月 ,112例CT或MRI证实术后病灶残瘤的BMG随机分为单纯常规放射治疗组 (单放组 )和常规放射治疗 +X线立体定向放射治疗 (立体定向放疗组 )。单放组 5 8例 ,男 40例 ,女 18例 ,年龄 16～ 76岁 (中位 40 .5岁 ) ,KPS6 0～ 70者 12例 ,>70者 46例 ;放疗前增强CT或MRI显示 ,肿瘤体积 1.0 0cm3 ～ 2 14 .78cm3 ,中位体积 2 1.0 0cm3 ;常规剂量分割照射 ,5次 /周 ,1.8～ 2Gy/次 ,总剂量 46 .2 0～ 6 5 .95Gy ,中位剂量 5 7.81Gy。立体定向放疗组共 5 4例 ,男 39例 ,女 15例 ,年龄 16～ 78岁 (中位年龄 44.5岁 ) ;KPS6 0～ 70者 8例 ,>70者 76例 ;肿瘤体积 1.76cm3 ～ 132 .0 0cm3 ,中位体积 2 2 .32cm3 ;先行常规照射 ,其照射野设计及其剂量分割与单放组相同 ,总剂量 45 .80～ 6 2 .45Gy ,中位剂量 5 5 .2 6Gy ;于常规放疗结束后 1周行立体定向放疗 ,采用非共面弧形旋转照射 ,PTV边缘剂量 8Gy～ 5 0Gy( 6 0 %～ 90 %等剂量曲线 ) ,中位 2 7.75Gy ;单次治疗 2 2例 ,分两次治疗者 2 8例 ,三次分割治疗者 6例 ,分次治疗的时间间隔为 1周 ;单次剂量 8Gy～ 5 0Gy ,中位单次剂量 15Gy。结果 治疗结束后 3个月CT?
Objective To investigate the role of X-ray stereotactic radiotherapy in the treatment of brain glioblastoma (BMG). Methods From October 1996 to October 1998, 112 cases of CT or MRI confirmed the postoperative residual tumor BMG were randomly divided into conventional radiotherapy group (single radiotherapy group) and conventional radiotherapy + X-ray stereotactic radiotherapy (three-dimensional Directional radiotherapy group). There were 58 males and 40 females, 18 females, aged from 16 to 76 years old (median 40.5 years), 12 cases of KPS6 0 to 70 (> 70), enhanced CT or MRI before radiotherapy , Tumor volume 1.0 0cm3 ~ 2 14 .78cm3, the median volume of 2 1.0 0cm3; conventional dose division irradiation, 5 times / week, 1.8 ~ 2Gy / time, the total dose 462.00 ~ 65.95Gy, median dose 5 7.81Gy. Stereotactic radiotherapy group 54 cases, 39 males and 15 females, aged 16 to 78 years (median age 44.5 years); KPS6 0 to 70 in 8 cases,> 70 in 76 cases; tumor volume 1.76cm3 ~ 132 .0 0cm3, the median volume of 2232cm3; first conventional irradiation, the radiation field design and dose division and the same group, the total dose of 45 .80 ~ 62.45Gy, the median dose of 52.6Gy; One week after the end of routine radiotherapy, stereotactic radiotherapy was performed with non-coplanar arc rotation irradiation. The marginal dose of PTV was 8 Gy to 50 Gy (60% -90% isodose curve) with a median of 2.75 Gy. Single treatment 2 2 cases, 28 cases treated twice, 6 cases treated three times, the time interval of treatment was 1 week; single dose 8Gy ~ 5 0Gy, the median single dose 15Gy. Results 3 months after the end of treatment CT?