Kramer S, Hendrickson F, Zelen M, Schotz W
Natl Cancer Inst Monogr. 1977 Dec;46:213-21.
Two consecutive studies have been performed by the Radiation Therapy Oncology Group on patients with metastatic brain tumors. Approximately 1,000 patients were entered into each trial. Treatment schedules of varying dose-time fractionations were used. Results were evaluated on the basis of improvement in general performance and neurologic function status. Survival also was recorded. Patients who received corticosteroids in conjunction with radiation therapy experienced a more rapid improvement in neurologic function than patients who did not receive steroid therapy. This was noted particularly in patients with poor neurologic function status. However, by the 4th week this difference had disappeared. Survival times were not altered by the addition of steroid therapy. Preliminary results of the second study suggest that ultra-short fractionation schedules are less effective than the longer ones used in the first study. A dose of 3,000 rads given in 10 equal fractions for a period of 2 weeks appeared to be the most satisfactory schedule for most patients with intracranial metastases.
放射治疗肿瘤学组针对转移性脑肿瘤患者进行了两项连续研究。每项试验纳入了约1000名患者。采用了不同剂量时间分割的治疗方案。结果根据总体表现和神经功能状态的改善情况进行评估。还记录了生存期。接受皮质类固醇联合放射治疗的患者，其神经功能改善速度比未接受类固醇治疗的患者更快。这在神经功能状态较差的患者中尤为明显。然而，到第4周时，这种差异消失了。添加类固醇治疗并未改变生存期。第二项研究的初步结果表明，超短分割方案不如第一项研究中使用的较长分割方案有效。对于大多数颅内转移瘤患者来说，在2周内分10等份给予3000拉德的剂量似乎是最令人满意的方案。
