论文部分内容阅读
目的观察螺旋断层放疗(Tomotherapy,Tomo)进行全中枢放疗(craniospinal irradiation,CSI)的急性毒副反应。方法回顾性分析6例实施Tomo治疗的病例资料,其中4例为生殖细胞瘤,2例为小脑髓母细胞瘤术后。临床靶区(clinicaltarget volumes,CTV)为术后瘤床(CTV1,50～56 Gy)、全脑和全脊髓(CTV2,28～36 Gy),每次1.8～2.0 Gy,1次/d,5次/周。毒副反应评价按通用不良反应术语标准3.0版本(CTCAE v3.0)。结果 2例因严重骨髓抑制未按计划完成全脑全脊髓照射。3级或3级以上反应:白细胞下降5例,贫血2例,血小板下降3例。恶心、呕吐均在2级和2级以下。病人均使用重组人粒细胞集落刺激因子,4例病人使用血小板集落刺激因子。结论 Tomo技术进行全脑、全脊髓照射需重视急性毒副反应。
Objective To observe acute toxicity of craniospinal irradiation (CSI) by Tomotherapy (Tomo). Methods Retrospective analysis of 6 cases of Tomo treatment of cases, of which 4 cases of germ cell tumors, 2 cases of cerebellar medulloblastoma postoperative. The clinical target volumes (CTVs) were postoperative tumor bed (CTV1, 50-56 Gy), whole brain and whole spinal cord (CTV2, 28-36 Gy), 1.8-2.0 Gy each time, Times / week Toxic side effects were evaluated according to the Universal Adverse Reaction Terminology Standard Version 3.0 (CTCAE v3.0). Results 2 cases of severe myelosuppression did not complete the whole brain as planned spinal cord irradiation. 3 or more than three reactions: leukopenia in 5 cases, 2 cases of anemia, thrombocytopenia in 3 cases. Nausea, vomiting are in 2 and 2 below. Patients used recombinant human granulocyte colony-stimulating factor and 4 patients used platelet-derived colony stimulating factor. Conclusion Tomo technique for whole brain and whole spinal cord irradiation should pay attention to acute toxicities and side effects.