Glanzmann C
Klinik für Radiotherapie, Universitätsspital Zürich.
Strahlenther Onkol. 1990 Feb;166(2):119-24.
Results of palliative high dose irradiation in 145 patients with brain metastasis of various carcinomas are reported. All patients had whole brain irradiation by parallel opposed lateral fields with a midline dose of 13 to 14 x 300 cGy in 2,5 to three weeks. Patients with solitary brain metastasis received a local boost with 5 x 200 cGy. Twelve patients had also surgical excision of the brain metastasis. 39% of the patients had a marked improvement (good or very good neurological function class) and 30% had a moderate improvement. Neurologic function was stabilized in an improved state for 93% of the remaining survival time. This result corresponds to the observations of the RTOG in a randomized study of various doses, resulting in a standard dose of 10 x 300 cGy, but there is a small subgroup with a relatively favourable prognosis benefitting from surgery and irradiation or irradiation alone with a higher dose and conventional fractionation.
报告了145例各种癌脑转移患者姑息性高剂量放疗的结果。所有患者均采用平行对置侧野全脑照射,中线剂量在2.5至3周内为13至14×300 cGy。孤立性脑转移患者接受5×200 cGy的局部加量照射。12例患者还接受了脑转移瘤手术切除。39%的患者有显著改善(神经功能分级为良好或非常良好),30%的患者有中度改善。93%的患者神经功能在剩余生存时间内稳定在改善状态。这一结果与放射治疗肿瘤学组(RTOG)在一项不同剂量的随机研究中的观察结果一致,该研究得出的标准剂量为10×300 cGy,但有一小部分预后相对较好的亚组患者从手术加放疗或单纯高剂量常规分割放疗中获益。