Clinical Study About Treatment Of Brainstem Gliomas By Gamma Knife Radiosurgery In Short-term Dose Fractionation

Objective To appraise the clinical effect of gamma knife radiosurgery for brainstem gliomas in short-term dose fraction.Methods To apply OUR-RGS/G revote gamma knife treated 30 cases of brainstem gliomas, to match every two similar treating condition cases,add up to 15 doubles, divided into groups.One was treated in once time dose,tumor edge dose 12.0 + 2.0 Gy,equal dose curve 50%~60%;the other was treated in fraction dose, tumor edge dose 8.0+2.0 Gy,equal dose curve 50%~60%.After gamma knife radiotherapy all cases were given chemotherapy in CCNU.Results To observe short-term effects(2w~3m),single group:improve 8 cases,no change 5 cases,worsened 1 case,died 1 case,short-term effective rate 86.7%;fraction group: improve 10 cases,no change 4 cases,worsened 1 case,no died case,short-term effective rate 93.3%.A11 cases were followed about 3~24m,average 12m, single group :improve 4 cases,no change 4 cases,worsened 4 case,died 3 case, effective rate 53.3% ; fraction group:improve 8 cases,no change 3 cases,worsened 2 case,died 2 case, effective rate 73.3%.Same periodical MRI showed: oedema reaction around tumor was more obvious than fraction group.It showed short-term dose fractionation can improve effect.There are significant variant(.P<0.05) between these two groups.Conclusions Gamma knife radiosurgery for brainstem gliomas in short-term dose fraction was better than once time high dose and its vice effects was less.