Lindegaard K F, Mørk S J, Eide G E, Halvorsen T B, Hatlevoll R, Solgaard T, Dahl O, Ganz J
J Neurosurg. 1987 Aug;67(2):224-30. doi: 10.3171/jns.1987.67.2.0224.
The postoperative survival time of 170 nonrandomized patients treated for cerebral oligodendrogliomas in Norway from 1953 to 1977 was studied. Survival times were significantly prolonged if postoperative irradiation was performed in addition to surgery (median survival time 26.5 vs. 38 months, p = 0.039). In the group without postoperative radiotherapy, the 5-year rate of survival was 27% compared with 36% in the irradiated patients. The respective survival rates after 8 years were 14% versus 17%; thus, there was little effect on long-term survival. Irradiation appears not to be of benefit after "total" removal. Patients with partly resected lesions appeared to benefit from postoperative radiotherapy; the median survival period after subtotal tumor resection was 37 months with and 26 months without radiotherapy (p = 0.0089). The findings also indicate that irradiation doses between 40 and 50 Gy were as effective as doses between 50 and 60 Gy in increasing the patients' probability of surviving 5 years after subtotal tumor resection. Since the risk of radiation necrosis is proportional to the dose applied, the lower dose is recommended. These conclusions were also valid when adjustments were made for prognostically significant histological and clinical features.
对1953年至1977年在挪威接受治疗的170例非随机脑少突胶质细胞瘤患者的术后生存时间进行了研究。如果除手术外还进行术后放疗,生存时间会显著延长(中位生存时间26.5个月对38个月,p = 0.039)。在未进行术后放疗的组中,5年生存率为27%,而接受放疗的患者为36%。8年后的生存率分别为14%和17%;因此,对长期生存影响不大。“全切”后放疗似乎没有益处。部分切除病变的患者似乎从术后放疗中获益;肿瘤次全切除后,接受放疗的中位生存期为37个月,未接受放疗的为26个月(p = 0.0089)。研究结果还表明,在提高肿瘤次全切除患者5年生存概率方面,40至50 Gy的放疗剂量与50至60 Gy的剂量效果相同。由于放射性坏死的风险与所应用的剂量成正比,因此推荐较低剂量。在对具有预后意义的组织学和临床特征进行调整后,这些结论仍然有效。