全脑全脊髓放疗不同照射方式的疗效

摘要

Objective: Aim The effect of radiotherapy to germinoma and medullblastoma under different radiation type were analyzed retrospectively, and the better radiation type was analyzxed. Methods: We collected 42 cases of CNS tumor with of germinoma and medullblastoma. The total CNS radiotherapy which composed by sequential radiation and sectionalized radiation was conducted and then observe the curative effect, side effects and the changes of he-matology and state of recurrence. Results: Of 42 cases 32 achieved complete response(CR ) after therapy. The sectionalized manner was showed a higher toxicity. The follow - up visit performed from 2004 to June 2010, with the average time of 19 months. We have got the complete data in 36 cases and 6 cases lost. The data showed that the recurrence was more occurred in the sectionalized manner. Conclusion: The total CNS radiotherapy showed a relatively better curative effect in the germinoma and medullblastoma, and the side effects are tolerabll. The sectionalized manner was extend the course of the treatment and the survival benefit didn't acquired in this manner, the sequential radiation was the better one in our research.%目的:回顾性分析不同照射方式下全脑全脊髓放疗对生殖细胞瘤及髓母细胞瘤的疗效,并探讨最佳放疗方法.方法:1999年8月至2010年2月本院收治的42例中枢神经系统肿瘤患者行术后全脑全脊髓放疗,放疗方式分为标准全脑全脊髓照射(连续照射)和分段照射(先全脑后全脊髓)两种类型,观察不同照射方式的近期疗效、不良反应、血液学毒性、远期疗效以及复发情况.结果:42例患者经全中枢照射治疗达完全缓解(complete response,CR)者32例.不同照射方式有一定差异,分段照射延长了疗程且不良反应较多,随访显示复发率高于连续照射组,分段照射并未使患者得到明显的生存获益.结论:术后全脑全脊髓放疗对生殖细胞瘤及髓母细胞瘤疗效较好,与以往文献资料相比,可明显提高治愈率及生存期.从最佳照射方式角度出发,分段照射延长疗程,且复发率高,仍以连续照射为佳.