Brada Michael, Stenning Sally Patricia
The Institute of Cancer Research and The Royal Marsden NHS Trust, Downs Road, Sutton, Surrey, UK.
Semin Oncol. 2003 Dec;30(6 Suppl 19):63-7. doi: 10.1053/j.seminoncol.2003.11.034.
While fractionated external beam radiotherapy remains the principal treatment in patients with histologically verified malignant glioma, its use in older patients and in patients with adverse prognostic features has not been subject to randomized studies. Hypofractionated partial brain irradiation offers a short, well-tolerated treatment with a palliative benefit for patients with a predicted median survival of less than 6 months. To assess its true efficacy in terms of survival and quality-of-life gain requires a formal randomized comparison with supportive care either alone or in combination with palliative chemotherapy and with radical radiotherapy. On present evidence, palliative radiotherapy remains the appropriate treatment for older patients and those with adverse prognostic features, but the final choice should be based on the patient's wishes moderated by the clinician's perception of the gain of treatment.
虽然分次体外束放射治疗仍是经组织学证实的恶性胶质瘤患者的主要治疗方法，但在老年患者和具有不良预后特征的患者中使用该方法尚未进行随机研究。短程分割局部脑照射为预计中位生存期少于6个月的患者提供了一种疗程短、耐受性良好且具有姑息疗效的治疗方法。要评估其在生存和生活质量改善方面的真正疗效，需要与单独的支持治疗或与姑息化疗及根治性放疗联合的支持治疗进行正式的随机对照比较。根据目前的证据，姑息性放疗仍是老年患者和具有不良预后特征患者的合适治疗方法，但最终选择应基于患者的意愿，并由临床医生对治疗获益的判断进行调整。
