Combs Stephanie E, Schulz-Ertner Daniela, Thilmann Christoph, Edler Lutz, Debus Juergen
Department of Radiation Oncology, German Cancer Research Center, Heidelberg, Germany.
Int J Radiat Oncol Biol Phys. 2005 Jul 1;62(3):797-802. doi: 10.1016/j.ijrobp.2004.11.011.
To retrospectively analyze the outcomes and benefits from radiation therapy (RT) as a component of multimodal treatment for oligodendroglioma and oligoastrocytoma, assessing local control and survival rates and evaluating prognostic factors.
We retrospectively reviewed 56 adult patients with supratentorial oligodendroglioma or oligoastrocytoma treated at our institution from January 1990 to December 2003 with fractionated stereotactic RT (FSRT).
Fractionated stereotactic RT was well tolerated in all patients, without side effects. Median survival and progression-free survival calculated from the initiation of radiotherapy were 48 months (range, 2-133 months) and 38 months (range, 2-132 months), respectively. Progression-free survival rates after radiation were 89% at 1 year and 52% at 5 years. Of 26 recurrences, 92% developed in field. With regard to histology, overall survival rates in the World Health Organization (WHO) Grade II group were 89% and 74% at 5 and 10 years, respectively. In patients with WHO Grade III tumors, overall survival rates at 5 and 10 years were 69% and 46%, respectively. No prognosticators could be identified for median survival and progression-free survival after radiotherapy. Median overall survival calculated from primary diagnosis was 77.5 months (range, 3-214 months). The Cox regression multivariate analysis for age and neurologic symptoms showed a significance of p = 0.003 for age and p = 0.037 for the presence of neurologic symptoms on overall survival since primary diagnosis.
Commonly, conventional conformal RT is applied in the treatment of brain tumors. In FSRT, the tumor volume can be irradiated with high doses, sparing volume of normal brain tissue. Our data are in accordance with survival times found in the literature. Ninety-two percent of all recurrences occurred within the defined target volume, confirming that reduction of the RT portals by the use of FSRT does not lead to an increased rate of recurrences at the field border or out of field. Fractionated stereotactic RT can therefore be implemented as an effective and safe modality in the therapy of primary oligodendroglioma and oligoastrocytoma.
回顾性分析放射治疗（RT）作为少突胶质细胞瘤和少突星形细胞瘤多模式治疗组成部分的疗效和益处，评估局部控制率和生存率，并评估预后因素。
我们回顾性分析了1990年1月至2003年12月在本机构接受分次立体定向放射治疗（FSRT）的56例幕上少突胶质细胞瘤或少突星形细胞瘤成年患者。
所有患者对分次立体定向放射治疗耐受性良好，无副作用。从放疗开始计算的中位生存期和无进展生存期分别为48个月（范围2 - 133个月）和38个月（范围2 - 132个月）。放疗后的无进展生存率1年时为89%，5年时为52%。26例复发中，92%发生在靶区内。关于组织学，世界卫生组织（WHO）II级组的5年和10年总生存率分别为89%和74%。WHO III级肿瘤患者的5年和10年总生存率分别为69%和46%。放疗后中位生存期和无进展生存期未发现预后因素。从初次诊断计算的中位总生存期为77.5个月（范围3 - 214个月）。年龄和神经症状的Cox回归多因素分析显示，年龄对自初次诊断后的总生存期p = 0.003有显著意义，神经症状的存在p = 0.037有显著意义。
通常，传统适形放疗用于脑肿瘤治疗。在分次立体定向放射治疗中，肿瘤体积可接受高剂量照射，同时 sparing volume of normal brain tissue（此处原文有误，推测可能是“sparing volume of normal brain”，意为“ sparing volume of normal brain”（保留正常脑组织体积））。我们的数据与文献中发现的生存时间一致。所有复发的92%发生在定义的靶区内，证实使用分次立体定向放射治疗减少放疗野不会导致野边界或野外复发率增加。因此，分次立体定向放射治疗可作为原发性少突胶质细胞瘤和少突星形细胞瘤治疗的一种有效且安全的方式。
