Department of Radiotherapy, PLA General Hospital, Beijing 100853, China.
Chin J Cancer Res. 2014 Jun;26(3):247-54. doi: 10.3978/j.issn.1000-9604.2014.05.02.
To evaluate the short-term clinical outcomes of intracranial germinoma patients treated with craniospinal irradiation (CSI) using helical tomotherapy (HT) system in our center.
Twenty-three patients who were treated with CSI in our center from January 2008 to July 2012 were collected, with an average age of 20. All of the patients' CSI used the HT system. The total doses were 27-36 Gy/15-20 F (1.5-2 Gy per fraction), and total local doses were 46-60 Gy/30-50 F (5 fractions per week). All female patients for CSI were treated with left-right parallel-opposed field irradiation to protect their ovarian functions. Median follow-up time was 30.9 months (range, 5-67 months). The SPSS19.0 software was used, and the overall survival (OS) was calculated using the Kaplan-Meier method.
Among 17 patients with assessable tumors, 9 cases (52.9%) were CR, 7 cases (41.2%) were PR, and 1 case (5.9%) was SD. Hematological toxicity was the severest side-effect occurred in the procedure of CSI. The level 1-4 acute leukopenia were 8.7%, 30.4%, 34.8% and 21.7% and the level 1-4 acute thrombopenia were 8.7%, 30.4%, 21.7% and 8.7%, respectively.
For primary intracranial germinomas, HT can be used to implement CSI for simplifying radiotherapy procedures, improving radiotherapy accuracy, enhancing protection of peripheral organs at risk (ORA) and guaranteeing therapeutic effects. With the acceptable acute and long-term toxicity, CSI using HT in intracranial germinoma patients can be a safe and alternative mode.
评估我院采用螺旋断层放疗（HT）系统行全脑全脊髓照射（CSI）治疗颅内生殖细胞瘤患者的短期临床疗效。
收集我院 2008 年 1 月至 2012 年 7 月采用 HT 系统行 CSI 的 23 例颅内生殖细胞瘤患者的临床资料，患者平均年龄 20 岁。所有患者的 CSI 均采用 HT 系统，总剂量 27-36 Gy/15-20 F（1.5-2 Gy/ 次），局部总剂量 46-60 Gy/30-50 F（5 次/周）。所有行 CSI 的女性患者均采用左右两野平行对穿照射以保护卵巢功能。中位随访时间 30.9 个月（5-67 个月）。采用 SPSS19.0 软件，采用 Kaplan-Meier 法计算总生存率（OS）。
17 例可评价肿瘤患者中，完全缓解（CR）9 例（52.9%），部分缓解（PR）7 例（41.2%），疾病稳定（SD）1 例（5.9%）。CSI 过程中最严重的副作用是血液学毒性，1-4 级急性白细胞减少分别为 8.7%、30.4%、34.8%和 21.7%，1-4 级急性血小板减少分别为 8.7%、30.4%、21.7%和 8.7%。
对于原发性颅内生殖细胞瘤，HT 可用于简化放疗过程，提高放疗准确性，增强对周围危险器官（ORA）的保护，保证治疗效果。HT 行 CSI 治疗颅内生殖细胞瘤患者具有可接受的急性和长期毒性，是一种安全的替代治疗方式。
