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題名:FRACTIONATED STEREOTACTIC RADIOTHERAPY FOR MALIGNANT GLIOMA     (26點)
腦部分次立體定位放射治療對惡性膠狀瘤
著者:Tao-Sang Chung(鍾道生) ;Jeng-Fong Chiou(邱仲峰) ;Chung-Yu Kao(高仲瑜) ;Jo-Ting Tsai(蔡若婷) ;Chi-Yuan Yeh(葉啟源) ;Chi-Ching Lo(羅濟慶) ;Ping-Ling Chen(陳品玲) ;Wen-Ta Chiou(邱文達)
出版地區:台灣
出版城市:台北市
學科:醫學綜合
關鍵字:立體定位放射治療 ; 惡性膠狀瘤 ; 存活率 ; Stereotactic radiotherapy ; Glioma ; survival
刊名:Therapeutic Radiology and Oncology
頁碼:147-159
語言:英語
摘要: 中文摘要PDF ; 英文摘要PDF

且的: 本研究是以回溯分析法來進行,以評估腦部分次立體定位放射治療對惡性神經膠質瘤的影響的初步研究結果口材料血 有注: 1 99 6 年6 月至1 99 8 年5 月的期間共有3 7 位經組織診斷為WHO 分級gra d e III 或IV神經膠質瘤病患( 1 7 位退化性星母細胞瘤, 20 位多形神經膠母細胞瘤) 在本院以腦部分次立體定位治療o 先以體外放射線治療累積劑量至中值劑量的格雷時再以分次立體定位放射治療於腫瘤部位追加劑量, 本院採用的立體定位技術為先於頭部植入3顆金屬球當作參考點,輔以電腦立體定位系統作治療計劃o 每日每次劑量為2 .0 格雷至3 . 0 格雷,治療5 至1 2次, 一般選擇以l2 個中心點, 4- 8 個非共面弧來治療o 利用Kap l an-Meier 方法計算存活曲線, 以單一變數與多重變數分析方式來測試不同預後因子與治療方式。 益是: 整體中值平均存活為2 2 個月, 1 年和2 年存活率為6 0 %和3 0 % 。後續追蹤影像檢查顯示在3 7位病人中有6位病人( 16% ) 腫瘤縮小大於5 0% ;腫瘤縮小少於50%或沒改變的有1 4位病人0 8 % ) , 腫瘤有擴大的佔1 7 位( 46% ) 。分析不同預後因子, 年齡( <5 0 歲) 、手術切除範圓的大小、腫瘤的體積大小(<2 0 ml ) ,以單一變數分析時與增加存活有關( P< 0. 0 5 ) 口多重變數分析時手術切除範圓大小、腫瘤的體積大小仍有統計學上的意義。所有病人在分次立體定位放射治療中情況穩定,只有5 位病患( 1 3% ) 產生急性毒性症狀但皆可藉由藥物得到良好的控制。 益益: 腦部分次立體定位放射治療, 對於惡性神經膠質瘤的初步治療多形神經膠母細胞瘤病患無疑是一個提供安全且可行的治療方式o 雖然對整體的存活率和l年存活率有幫助, 但無法觀察到在整體存活率或無疾病惡化存活率有明顯的劑量效應關係D
Purpose : This study is a retrospective analysis to evaluate the impact of fractionated stereotactic radiotherapy (FSRT) on malignant glioma. Material and Methods : Between June 1996 and May 1998, 37 patients with histologically proven WHO grade III or IV glioma (17 Anaplastic astrocytoma, 20 Glioblastoma multiforme) were treated at Taipei Medical University hospital with FSRT. External beam radiotherapy (EBRT) delivered a median dose of 46 Gy which is followed by stereotactic radiotherapy. A frameless fractionated stereotactic radiotherapy was used to boost the tumor bed, using daily fraction of 2.0 -3.0 Gy for 5 to 12 fractions. Non-coplanar arcs (4-8 arcs, median 4 arcs) with 1 to 2 isocenters were mostly used. Survival curves were calculated using the Kaplan-Meier method. Prognostic factors and different treatment variables were tested by univariate and multivariate analysis. Results : Overall median survival was 22 months. One year and 2-year survival rate were 60% and 30% respectively. Follow up imaging study showed tumor reduction greater than 50% in 6 patients (16%), reduction less than 50% or unchanged in 14 patients (38%) and progression in 17 of the 37 patients (46%). On analysis of different prognostic factors, patient’s age (<50 years and ?50 years), extent of surgical resection, and tumor volume (<20 ml) were correlated with survival in univariate analysis (p<0.05). Tumor volume and extent of surgical resection remained significant in multivariate analysis. The performance status remained stable for all patients during FSRT and only 5 patients (13%) suffered from treatment related acute toxicity with good medication control. Conclusions : Fractionated stereotactic radiotherapy provides a safe and feasible technique in the primary treatment of malignant gliomas. Although the overall survival and 1 year survival is encouraging, we did not observe a significant dose-effect relationship on overall and progression-free survival. Large series study with long term follow-up is indicated.


    

本卷期目次
Therapeutic Radiology and Oncology
不同骨盆腔固定器在攝護腺癌三度空間立體順形放射治療技術之評估/ 賴朝宗劉裕明吳曉萍蕭正英李玉麟季匡華顏上惠
Radiotherapy of Conjunctival Lymphoma with A Specially Designed Lens Block/ Wei-Chung HsuLai-Lei TingShiu-Chen JengPo-Ming WangLouis Lui TakSzu-Jong ChenNa-Na ChungGau-De Lin
電腦輔助設計三度空間真實表面數學模式於放射治療定位影像之應用/ 吳錦榕孫述平許文林阮昭銘
Primary Central Nervous system Lymphoma - 3 Cases Report/ Chi-Fu HungJyh-Der LeuChien-Ru Liu
放射治療機加值型網路劑量品質保證系統/ 劉雪君張淑瓊趙良曉李玉麟顏上惠
Fractiona Stereotactic Radiotherapy for Malignant Glioma/ Tao-Sang ChungJeng-Fong ChiouChung-Yu KaoJo-Ting TsaiChi-Yuan YehChi-Ching LoPing-Ling ChenWen-Ta Chiou
Radiotherapy is Effective in the Treatment of Hepatocellular Carcinoma with Right Atrium Invasion - Report of A Case/ Chih-Ping ChenYee ChaoChung-Pin LiMing-Yu LaiKwan-Hwa ChiSang-Hue YenFull-Young ChangShou-Dong Lee
An Effective, Efficient and Safe Method to Deliver A Modified 3-D Radiotherapy in Locally Advanced Nasopharyngeal Carcinoma/ Yih-Lin ChungSkye Hon-Giun ChengStella Y.C. TsaiJason C. ChengShu-Li KangJames Jer-Min Jian
Alveolar Soft Part Sarcoma: Clinical Outcome of Two Patients and Review of the Literature/ Helen H.W. ChenFen-Fen ChenWen-Tsung HuangLi-Li ChengHenry W.C. Leung
利用氣泡偵檢器量測醫用直線加速器光中子研究/ 林招膨林松彥朱鐵吉劉幕台張東浩黃昭源
AN EFFECTIVE, EFFICIENT AND SAFE METHOD TO DELIVER A MODIFIED 3-D RADIOTHERAPY IN LOCALLY ADVANCED NASOPHARYNGEAL CARCINOMA/ Yih-Lin ChungSkye Hon-Giun ChengStella Y. C. TsaiJason C. ChengShu-Li KangJames Jer-Min Jian
FRACTIONATED STEREOTACTIC RADIOTHERAPY FOR MALIGNANT GLIOMA/ Tao-Sang ChungJeng-Fong ChiouChung-Yu KaoJo-Ting TsaiChi-Yuan YehChi-Ching LoPing-Ling ChenWen-Ta Chiou
RADIOTHERAPY OF CONJUNCTIVAL LYMPHOMA WITH A SPECIALLY DESIGNED LENS BLOCK/ Wei-Chung HsuLai-Lei TingShiu-Chen JengPo-Ming WangLui Louis TakSzu-Jong ChenNa-Na ChungGau-De Lin
電腦輔助設計三度空間真實表面數學模式於放射治療定位影像之應用/ 吳錦榕孫述平許文林阮昭銘
不同骨盆腔固定器在攝護腺癌三度空間立體順形放射治療技術之評估/ 賴朝宗劉裕明吳曉萍蕭正英李玉麟季匡華顏上惠
利用氣泡偵檢器量測醫用直線加速器光中子研究/ 林招膨林松彥朱鐵吉劉幕台張東浩黃昭源
放射治療機加值型網路劑量品質保證系統/ 劉雪君張淑瓊趙良曉李玉麟顏上惠
PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA-3 CASES REPORT/ Chi-Fu HungJyh-Der LeuChien-Ru Liu
ALVEOLAR SOFT PART SARCOMA: CLINICAL OUTCOME OF TWO PATIENTS AND REVIEW OF THE LITERATURE/ Helen H. W. ChenFen-Fen ChenWen-Tsung HuangLi-Li ChengHenry W. C. Leung
RADIOTHERAPY IS EFFECTIVE IN THE TREATMENT OF HEPATOCELLULAR CARCINOMA WITH RIGHT ATRIUM INVASION-REPORT OF A CASE/ Chih-Ping ChenYee ChaoChung-Pin LiMing-Yu LaiKwan-Hwa ChiSang-Hue YenFull-Young ChangShou-Dong Lee
 
   
 
   

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