Tinkler D, Lucraft H H
Northern Centre for Cancer Treatment, Newcastle General Hospital, Newcastle upon Tyne, UK.
Clin Oncol (R Coll Radiol). 1995;7(3):179-83. doi: 10.1016/s0936-6555(05)80512-6.
The case notes were reviewed of 55 patients treated with craniospinal irradiation for cerebellar medulloblastoma during the period 1970-1992. Twenty patients treated by various techniques before 1978 had a survival at both 5 and 10 years of 33%. Thirty-five patients treated from 1978 onwards were irradiated using a standard technique, which is described; their actuarial disease free survival was 59% at 5 years and 47% at 10 years. Our results are similar to those reported from other centres. The recent literature is reviewed. Irradiation of the whole craniospinal axis (CSA) is necessary for disease control, but the optimum dose of radiation is still disputed. It is likely to be in excess of 25 Gy but less than 35 Gy to the whole CSA, and 50 Gy or greater to the posterior fossa. The role of adjuvant chemotherapy is still not proven. The clinical significance of the dose inhomogeneity across the junction between the cranial and spinal fields, and the effect of feathering, are uncertain.
回顾了1970年至1992年期间接受颅脊髓照射治疗小脑髓母细胞瘤的55例患者的病历。1978年前采用各种技术治疗的20例患者5年和10年生存率均为33%。1978年起接受治疗的35例患者采用标准技术进行照射（该技术有描述）；其无病生存率5年时为59%，10年时为47%。我们的结果与其他中心报告的结果相似。对近期文献进行了综述。照射整个颅脊髓轴（CSA）对于疾病控制是必要的，但最佳放射剂量仍存在争议。整个CSA的剂量可能超过25 Gy但小于35 Gy，后颅窝剂量为50 Gy或更高。辅助化疗的作用仍未得到证实。颅脊髓野交界处剂量不均匀的临床意义以及野边缘修整的影响尚不确定。
