原發惡性腦瘤的放射線治療

This is a retrospective analysis of 194 patients with primary malignant brain tumor, who registered between January 1, 1970 and December 31, 1979 in cancer registration, Cancer Therapy Center, Veterans General Hospital, Taipei, Taiwan, R.O.C. There were 36 cases of glioblastoma multiforme, 86 cases of malignant astrocytoma (grade Ⅲ and a few grade Ⅱ), 22 of medulloblastoma, 12 of oligodendroglioma, 11 of ependymoma or ependymoblastoma and 27 cases of other types. There were 141 male cases with ages ranging from ito 81 years with a mean of 33.3±19.3 and median of 34 years. About 48%(90/194) were below 29 years of age. Ninety-nine of 194 cases had either radiotherapy alone or supplementary treatment with radiotherapy following surgery. We analyzed multiple prognostic factors. The factors of importance included postoperative radiotherapy; female in glioblastoma multiforme; the primary tumor dose above 5000 rads and/or whole brain irradiation in malignant astrocytoma and glioblastoma multiforme; the primary tumor dose above 4500 rads in ependymoma, medulloblastoma and oligodendroglioma; and spinal axis irradiation above 2000 rads in ependymoma and medulloblastoma that produced a better prognosis than in other groups. The difference was statistically significant. The actuarial 5-year survial rate was 7% with glioblastoma multiforme, 24% with malignant astrocytoma, 54% with medulloblastoma, 49% with oligodendroglioma, 18% with ependymoma or ependymoblastoma and 24% with other brain tumors (P＜0.005).