Shin K H, Urtasun R C, Fulton D, Geggie P H, Tanasichuk H, Thomas H, Muller P J, Curry B, Mielke B, Johnson E
Cancer. 1985 Aug 15;56(4):758-60. doi: 10.1002/1097-0142(19850815)56:4<758::aid-cncr2820560410>3.0.co;2-2.
Various attempts have been made to improve the effectiveness of radiation in the treatment of cerebral malignant astrocytomas. A trend favoring multiple daily fractionated (MDF) radiation therapy over conventional single daily fractionated (CF) radiation therapy was identified in our previous study. In order to assess the effect of MDF with and without misonidazole, a province-wide prospective randomized trial was initiated in January 1981. By March 1984, 124 patients with histologically verified grade III and IV astrocytomas were randomized to CF (5800 cGy/6 weeks/30 fractions), MDF (6141 cGy/4.5 weeks/69 fractions at 89 cGy every 3-4 hours, three times a day) and MDF in combination with misonidazole (1.25 g/m2 three times weekly for the first 3 weeks). Thirty-eight patients were randomized to CF, 43 patients to MDF, and 43 patients to MDF and misonidazole. At the preliminary assessment in July 1984, the median survival time was 27 weeks for the CF group, 39 weeks for the MDF group and 49 weeks for MDF and misonidazole group. The 1-year actuarial survival rate from surgery was 20% for CF group, 41% for MDF group, and 45% for MDF and misonidazole group. There is a statistically significant difference (P less than 0.001) between the CF and MDF group. However, the addition of misonidazole does not significantly alter survival.
人们已经进行了各种尝试来提高放射治疗脑恶性星形细胞瘤的疗效。在我们之前的研究中发现了一种倾向于采用每日多次分割（MDF）放射治疗而非传统每日单次分割（CF）放射治疗的趋势。为了评估使用与不使用甲硝唑的MDF的效果，1981年1月启动了一项全省范围的前瞻性随机试验。到1984年3月，124例经组织学证实为III级和IV级星形细胞瘤的患者被随机分为CF组（5800 cGy/6周/30次分割）、MDF组（6141 cGy/4.5周/69次分割，每3 - 4小时89 cGy，每天3次）以及MDF联合甲硝唑组（前3周每周3次，每次1.25 g/m²）。38例患者被随机分到CF组，43例患者被分到MDF组，43例患者被分到MDF联合甲硝唑组。在1984年7月的初步评估中，CF组的中位生存时间为27周，MDF组为39周，MDF联合甲硝唑组为49周。CF组术后1年的精算生存率为20%，MDF组为41%，MDF联合甲硝唑组为45%。CF组和MDF组之间存在统计学显著差异（P小于0.001）。然而，添加甲硝唑并没有显著改变生存率。
