Nemoto K, Ogawa Y, Matsushita H, Takeda K, Takahashi C, Fujimoto K, Nomiya T, Saito H, Takai Y, Yamada S
Department of Radiation Oncology, Tohoku University School of Medicine, Sendai 980-8574, Japan.
Oncol Rep. 2001 Jan-Feb;8(1):103-6. doi: 10.3892/or.8.1.103.
From 1989 to 1995, we administered a combination of large and small fraction doses (UFX, uneven fractionation) for patients with malignant gliomas. In this study, we compared the treatment outcomes of radiation therapy by uneven fractionation to that of historical control which was treated with radiation therapy by conventional fractionation (CFX). The pathologic classification was anaplastic astrocytoma (AA) in 120 and glioblastoma multiforme (GBM) in 64 patients. Of the 184 patients, 89 patients received a conventional fractionation schedule (CFX) of radiation (2 Gy/fraction, 5 times/week; total, 60 Gy/6 weeks). The other 95 patients received an uneven fractionation schedule (UFX) of radiation (5 Gy on Monday, 1 Gy from Tuesday through Friday; total, 63 Gy/7 weeks). The one-, two-, and five-year survival rates of the AA patients were 74%, 55%, and 30%, respectively. The five-year survival rates of AA patients who received CFX and UFX schedule of radiation were 24% and 38%, respectively. In the GBM patients, the five-year survival rates were 12% in patients who received CFX and 11% in patients who received UFX. UFX seemed to be more effective than CFX for treating AA patients. In multivariate analysis using the Cox regression analysis, which included various patients and treatment characteristics, age, histology and extent of surgery were the significant prognostic factors. In conclusion, UFX is an promising fractionation method for AA patients but not for GBM patients.
1989年至1995年期间，我们对恶性胶质瘤患者采用了大分割剂量与小分割剂量相结合的方式（不均匀分割，UFX）。在本研究中，我们将不均匀分割放疗的治疗结果与采用常规分割放疗（CFX）的历史对照结果进行了比较。病理分类为间变性星形细胞瘤（AA）120例，多形性胶质母细胞瘤（GBM）64例。184例患者中，89例接受了常规分割放疗方案（CFX）（2Gy/次，每周5次；总量，60Gy/6周）。另外95例患者接受了不均匀分割放疗方案（UFX）（周一5Gy，周二至周五1Gy/天；总量，63Gy/7周）。AA患者的1年、2年和5年生存率分别为74%、55%和30%。接受CFX和UFX放疗方案的AA患者的5年生存率分别为24%和38%。在GBM患者中，接受CFX的患者5年生存率为12%，接受UFX的患者为11%。对于治疗AA患者，UFX似乎比CFX更有效。在使用Cox回归分析的多因素分析中，纳入了各种患者和治疗特征，年龄、组织学和手术范围是显著的预后因素。总之，UFX是一种有前景的分割方法，适用于AA患者，但不适用于GBM患者。
