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1、低分化脑胶质细胞瘤术后放疗“野中野”照射临床研究【摘要】「I的：探讨低分化脑胶质细胞瘤术后放射治疗“野屮野”照射技术的疗效。方法：28例患者，病理确诊为低分化(III~IV级)神经胶质细胞瘤；无明显的颅内高压；术后头颅CT或MRI,示局部肿瘤残留或复发。随机分为观察组(即野中野治疗)13例，对照组(即常规治疗)15例。观察组采用大野全脑照射Dt4500cGY/25次/5周，根据CT及(或)MR1,肿瘤边缘外放lcm,设2〜3个小野Dtl500cGY/10次/5周，小野与大野照射间隔至少6小时。对照组先采用全脑照射4000cGY/20次/4周，结束后小野追加，Dt2000cGY/10次/
2、2周。结果:随访率100%。1、2和3年生存率在观察组和对照组分别为69.2%、53.9%、35.9%和60%、26.7%、20%,两组比鮫差异无统计学意义(P>0.05)o中位主存期分别为26个月和17个月。结论：“野中野”放射治疗低分化脑胶质细胞瘤较常规治疗方案对以提高肿瘤患者的1、2和3年生存率，可能与“野中野”照射方法提高了局部放射生物效应，延缓肿瘤复发有关。【关键词】低分化脑胶质细胞瘤；放射治疗；野屮野ClinicalstudyonpostoperativeradiotherapybyMfield-in-fieldMtechniqueforhigh-gradebraingli
3、omaWANGYan,MAJianbo,ZHAOHongyu,etal(DepartmentofRadiotherapy,AffiliatedHospitalofNantongUniversity,Nantong226001)[Abstract]Objective：ToevaluatetheeffectsofradiotherapybyMfield-in-fieldMtechniqueforhighgradebrainglioma.Method：Twentyeightpatientswithhighgrade(III-IV)braingliomaafteroperationwerera
4、ndomizedintotwogroups(trialandcontrolgroup).AllpatientswereconfirmedbypathologyandCTorMRscan.Thirteencasesof(trialgroup,TG)weretreatedbynfield-in-fieldntechniquewhichwasdeliveredby1.8Gyperfractionand5fractionsaweekinwholebrainfieldwithtotaldosesof45Gyinfiveweeksand1.5Gyperfractionand2fractionsaw
5、eekinlocalfieldwithtotaldosesof15Gyinthecorrespondingperiod,withanintervalof6hoursfromwholebrainirradiation.Fifteenpatientsof(controlgroup、CG)weretreatedbyroutineirradiationwhichwasdeliveredby2.0Gyperfractionand5fractionsaweekinwholebrainfieldwithtotaldosesof40Gyinfourweeks,and2.0Gyperfractionan
6、d5fractionsaweekinlocalfieldwithtotaldosesof20Gyintwoweekssequentially.Results：Thel-,2-and3-yearsurvivalrateswere69.2%,53.9%,35.9%inTGand60%,26.7%,20%inCGrespectively.ButPvaluewas0.1197intheLog-ranktest.Themedialsurvivalspanswere26and17months.Conclusion：TheHfield-in-field,rtechniqueforhighgradeb
7、raingliomamayincreasethe1-,2-and3-yearsurvivalrates・Theimprovementof2-yearsurvivalrateishigherthanthatof1-or3-year.Thistechniquemayincreasethelocalradiobiologicaleffectanddeferthetumorrecurrence[Keywords]High-gradebraingliom
