脑转移瘤患者两种放疗分割模式的疗效及放射性脑损伤评估

发布时间：2018-03-02 18:21

本文选题：脑肿瘤　切入点：肿瘤转移　出处：《医学与哲学(B)》2015年10期 　论文类型：期刊论文

【摘要】：比较A组全脑放疗DT 30Gy/10次/2周后局部推量DT 30Gy/15次/3周及B组全脑放疗DT 40Gy/20次/4周后局部推量DT 20Gy/10次/2周两种放疗分割模式治疗脑转移瘤的疗效,并评估其放射性脑损伤,优化治疗方案。回顾性分析脑转移瘤患者155例,根据放疗分割模式不同,纳入A组79例,B组76例,放疗后行MRI扫描,应用RECIST1.1实体瘤评估标准对放疗后的效果进行评估,采用SOMA对放疗后的毒性反应进行分级。以Wilcoxon秩和检验评估放疗疗效及放疗后的毒性反应。结果显示采用RECIST1.1标准,B组疗效优于A组(Z=-3.036,P0.05,A组平均秩为88.15,B组平均秩为67.45),SOMA分级显示B组放射性脑损伤轻于A组(主观指标Z=-3.126,P0.05,A组平均秩为88.67,B组平均秩为66.91;客观指标Z=-2.900,P0.05,A组平均秩为67.87,B组平均秩为67.74)。全脑放疗DT 40Gy/20次/4周后局部推量DT 20Gy/10次/2周的剂量分割模式既达到治疗效果,又可减轻放射性脑损伤,患者临床获益更大。
[Abstract]:To compare the curative effect of local push DT30 Gy / 15 times / 3 weeks after whole brain radiotherapy in group A and DT 40 Gy / 20 times / 20 / 4 weeks in group B in treating brain metastases, and evaluate the radiation-induced brain injury. Objective: to analyze retrospectively 155 patients with brain metastases. According to the different fractionation mode of radiotherapy, 76 patients were included in group A (79 cases) and group B (76 cases). MRI scan was performed after radiotherapy. The evaluation criteria of RECIST1.1 solid tumor were used to evaluate the effect of radiotherapy. SOMA was used to grade the toxic reaction after radiotherapy. The Wilcoxon rank sum test was used to evaluate the curative effect of radiotherapy and the toxic reaction after radiotherapy. The results showed that the curative effect of group B with RECIST1.1 standard was better than that of group A (group A), the average rank of group A was 88.15% and the average rank of group B was 67.45%. Grade A showed that radiation brain damage in group B was lighter than that in group A (the average rank of group A was 88.67%, the average rank of group B was 66.91; the average rank of group A was 67.87% in group A; the average rank of group B was 67.74 4 weeks after radiotherapy of DT 40 Gy / 20; The dose division mode has achieved therapeutic effect. It can also reduce the radiation brain injury, and the clinical benefit of the patients is greater.
【作者单位】：辽宁医学院附属第一医院放射线科;辽宁医学院附属第三医院肿瘤放射治疗科;辽宁医学院附属第一医院核医学科;
【分类号】：R739.41;R730.55

【参考文献】