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[成年脑肿瘤患者放疗后进行性精神衰退]

[Progressive mental deterioration after radiotherapy in adult patients with brain tumors].

作者信息

Takeda N, Tanaka R, Ibuchi Y, Hondou H

机构信息

Dept. of Neurosurgery, Brain Research Institute, Niigata Univ.

出版信息

Gan No Rinsho. 1989 Sep;35(11):1330-8.

PMID:2810776
Abstract

We report a study on changes of mental function in twenty five adult patients with cerebral low-grade gliomas after radiotherapy. None of them had shown mental deterioration before radiotherapy nor tumor recurrence after radiotherapy. Radiation was given at a dose of 48 to 78 Gy (mean: 54.2 Gy). Patients were assigned for mental functional levels according to Karnofsky performance scale (KPS) after radiotherapy. Ten patients (40%) were normal. Seven patients (28%) showed moderate disabilities and 8 (32%) severe disabilities. The median interval time from radiotherapy to the onset of mental deterioration was 2.5 years in the moderate group and 1.6 years in the severe group. CT findings in severe group demonstrated severe brain atrophy and diffuse low density in the white matter after radiotherapy. The risk factors responsible for progressive mental deterioration after radiotherapy may be radiation site and size (whole frontal lobe), total dose (over 60 Gy) and patients age at the time of radiotherapy (over 60 yrs).

摘要

我们报告了一项关于25例成年脑低级胶质瘤患者放疗后心理功能变化的研究。他们在放疗前均未出现精神衰退,放疗后也均未出现肿瘤复发。放疗剂量为48至78 Gy(平均:54.2 Gy)。放疗后根据卡诺夫斯基表现量表(KPS)对患者的心理功能水平进行评定。10例患者(40%)正常。7例患者(28%)表现为中度残疾,8例(32%)表现为重度残疾。中度组从放疗到精神衰退开始的中位间隔时间为2.5年,重度组为1.6年。重度组的CT检查结果显示放疗后严重脑萎缩和白质弥漫性低密度。放疗后导致进行性精神衰退的危险因素可能是放疗部位和范围(整个额叶)、总剂量(超过60 Gy)以及放疗时患者的年龄(超过60岁)。

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