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有关原发性脑肿瘤,垂体瘤,脑以外肿瘤放疗后脑坏死的报道屡见不鲜。但脑坏死与放射的剂量、时间、分割、体积之间的关系仍不清楚。许多学者对此进行过探讨,均因方法不当未能成功。本文的目的在于阐明脑放射性坏死的发生率和脑坏死与放射的剂量,时间、分割、体积之间的关系。作者研究了1974至1976年的152例原发性脑肿瘤和垂体瘤放疗后病人。其中131例>15岁,余均为儿童。139例剂量为4500rad或更多,每次180～200rad。139例当中有7例经放射治疗后发生了为组织学所证实的脑放射性坏死。该7例病人的中位生存期为14个月。脑坏死的组织学来源有4例来自尸检,2例来自再次手术,1例来自穿刺活检,有3例脑坏死灶远离肿瘤,2例靠近肿瘤,2例在瘤床内。
About primary brain tumors, pituitary tumors, brain tumor radiotherapy outside of brain necrosis after the reports are common. However, the relationship between the dose of brain necrosis and radiation, time, segmentation, volume is still unclear. Many scholars have discussed this, because of improper methods failed. The purpose of this article is to elucidate the incidence of brain radiation necrosis and the relationship between brain necrosis and radiation dose, time, segmentation, volume. The authors studied 152 patients with primary brain tumors and pituitary tumors after radiotherapy from 1974 to 1976. Of these, 131 were> 15 years old and the remaining were children. 139 doses of 4500rad or more, each 180 ~ 200rad. Seven of the 139 patients developed histologically-confirmed brain radioactive necrosis after radiotherapy. The seven patients had a median survival of 14 months. Histopathologic sources of brain necrosis were 4 from autopsy, 2 from reoperation, 1 from biopsy, 3 from brain necrosis to tumor, 2 from tumor, and 2 within tumor bed.