Kivonat:
STUDY OBJECTIVE: Description and evaluation of radiotherapy of
inoperable tumours of central nervous system. New possibilities
in radiotherapy planning. MATERIALS AND METHODS: Between 1987
and 2004, 58 patients (30 boys and 28 girls, mean age 8.5+/-4.3
years) with brain stem tumours were treated with 6 MV or 9 MV
photons of the linear accelerator, or with telecobalt. The doses
administered ranged from 30 to 71.2 Gy; mean 51.7+/-8.4 Gy.
Treatment in each case was performed according to CT- and/or MR-
based radiotherapy plan. As of 2000, in case of 16 patients a 3D
conformal irradiation plan has been prepared. RESULTS: All
patients were followed. The mean follow-up period was 21.8
months (range: 7 to 158 months). The mean duration of symptoms
prior to diagnosis was 6.6+/-8.1 weeks (range: 1-52 weeks).
Overall survival (OS) and progression-free survival (PFS) rates
for all 58 patients were 39.9% and 21.2% at 1 years, 19.1% and
14.7% at 2 years, and 14.8% and 14.7% at 3 years respectively.
The following factors were of prognostic influence on the OS in
univariate analysis: duration of symptoms (< or = 2 months vs.
>2 months, p=0.0081), radiological response (p < 0.0001) and
clinical improvement (p = 0.0003). Prognostic factors for PFS
were similar to those predicting for OS. Multivariate analysis
revealed that the radiological (OS, p = 0.0034, PFS, p = 0.024)
and clinical (OS, p = 0.026, PFS, p = 0.044) improvement 6 weeks
after completion of radiotherapy were of prognostic
significance. CONCLUSION: Accurate field arrangement, precise
patient fixation, and CT- and MR-based 3D conformal radiotherapy
planning may result in better outcome of disease as well as
minimal effect on surrounding normal tissues. Radiotherapy
should be provided also for histologically not verified tumours.
Sixty-eight percent of these patients had a transitory 20.6-
month improvement, and 12.1% of them completely recovered.