间质内放射治疗深部脑肿瘤
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Interstitial brachytherapy in treatment of deep brain tumors
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    摘要:

    目的:了解间质内放射治疗脑深部肿瘤的效果,以利于提高间质内放射疗效。方法:在不同时间段,应用3种不同方式和剂量对 173 例患者脑深部肿瘤进行间质内放射治疗,分期进行追踪随访。结果:全组无手术死亡,随访 5-82 个月,其中星形细胞瘤Ⅰ?Ⅱ级3年生存率为54.5%,5年生存率为38.6%;Ⅲ?Ⅳ级1年生存率为11.6%,2年生存率为72.0%,3年生存率为16.2%。影像学随访结果:肿瘤完全消失15例(8.7%);肿瘤直径缩小在80%以上的29例(16.8%);缩小30%?50%者81例(46.8%)。完全消失的肿瘤为颅内恶性淋巴瘤、松果体区生殖细胞瘤、部分成胶质细胞瘤和转移瘤等。结论:为减少照射后的并发症,提高治疗效果,对颅内不同部位和不同性质肿瘤的内放射治疗应选用不同的照射剂量,以超分割内照射加外照射方法较优。

    Abstract:

    Objective:To assess and improve the therapeutic effect of interstitial brachytherapy. Methods: A hundred and seventy-three patients with deep brain tumors were treated with interstitial radio therapy through 3 different methods and at 3 different doses in different phases, they were followed up in different periods. Results: No operative death occured in all treated patients. Follow-up of 5-82 months revealed that 3 years survival rate of astrocyte tumors patients of Ⅰ?Ⅱ degrees was 54.5%, the survival rate of 5 years was 38.6%; one year with Ⅲ?Ⅳ degrees was 11.6%, two years was 72.0%, three years was 16.2%. The result of radiology follow-up survey indicated: fifteen cases with tumors completely disappeared (8.7%); 29 cases with tumors dimension shrinking over 80%(16.8%); 81 cases with shrinking 30%?50%(46.8%). Tumors of complete disapperance were intracranial malignant lymphoma, pineal cell tumors, multiform gliblastoma and metastatic tumors etc. Conclusion: To decrease the complications of radiation, improve the effect of treatment, different locations and properties of intracranial tumors should be treated with different radiation doses. The method of ultra-segmentation plus extra-radiation are better.

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