Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
권호 표지

The Outcome of Glioblastoma Patients Treated with Surgery and Radiation Therapy

두개 내 다형성아교모세포종 환자의 방사선치료 결과

  • Nam Hee Rim (Department of Radiation Oncology Samsung Medical Center) ;
  • Lim Do Hoon (Department of Radiation Oncology Samsung Medical Center) ;
  • Ahn Yong Chan (Department of Radiation Oncology Samsung Medical Center) ;
  • Lee Jung I1 (Department of Neurosurgery, Samsung Medical Center) ;
  • Nam Do-Hyun (Department of Neurosurgery, Samsung Medical Center) ;
  • Kim Jong Hyun (Department of Neurosurgery, Samsung Medical Center) ;
  • Hong Seung-Chyul (Department of Neurosurgery, Samsung Medical Center) ;
  • Lee Jeong Eun (Department of Radiation Oncology Samsung Medical Center) ;
  • Kang Min Kyu (Department of Radiation Oncology Samsung Medical Center) ;
  • Park Young Je (Department of Radiation Oncology Samsung Medical Center) ;
  • Kim Kyung Ju (Department of Radiation Oncology Samsung Medical Center) ;
  • Park Won (Department of Radiation Oncology Samsung Medical Center) ;
  • Huh Seung Jae (Department of Radiation Oncology Samsung Medical Center)
  • 남희림 (성균관대학교 의과대학 삼성서울병원 방사선종양학과) ;
  • 임도훈 (성균관대학교 의과대학 삼성서울병원 방사선종양학과) ;
  • 안용찬 (성균관대학교 의과대학 삼성서울병원 방사선종양학과) ;
  • 이정일 (성균관대학교 의과대학 삼성서울병원 신경외과) ;
  • 남도현 (성균관대학교 의과대학 삼성서울병원 신경외과) ;
  • 김종현 (성균관대학교 의과대학 삼성서울병원 신경외과) ;
  • 홍승철 (성균관대학교 의과대학 삼성서울병원 신경외과) ;
  • 이정은 (성균관대학교 의과대학 삼성서울병원 방사선종양학과) ;
  • 강민규 (성균관대학교 의과대학 삼성서울병원 방사선종양학과) ;
  • 박영제 (성균관대학교 의과대학 삼성서울병원 방사선종양학과) ;
  • 김경주 (성균관대학교 의과대학 삼성서울병원 방사선종양학과) ;
  • 박원 (성균관대학교 의과대학 삼성서울병원 방사선종양학과) ;
  • 허승재 (성균관대학교 의과대학 삼성서울병원 방사선종양학과)
  • Published : 2004.06.01
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Abstract

Propose: To Analyze the survival outcomes and prognostic factors In glioblastoma patients treated with surgery and radiation therapy. Materials and Methods : One hundred twenty glloblastoma patients treated with postoperative radiation therapy from 1994 to 2003 at Samsung Medical Center were retrospectively reviewed. Surgical extents were gross total resection in 22 patients (18$\%$), subtotal resection in 69 (58$\%$), and biopsy only in 29 (24$\%$). The median radiation dose was 50 Gy, ranging from 45 Gy to 72 Gy The median follow-up period was 12 months ranging from 2 to 52 months. Results The overall 1- and 2-year survival rates were 52$\%$ and 14$\%$, respectively, and the median survival duration was 13 months. Favorable prognostic factors by Uunivarlate analyses of prognostic factors on 1-year survival rate were revealed that age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.03), single lesion (p=0.02), and gross total resection (p=0.04), were the favorable prognostic (actors. and by Mmultlvarlate analyses were revealed that female (p<0.01), age under 50 (p<0.01), ECOG performance status 0 or 1 (p=0.05) and gross total resection (p=0.05) were the favorable prognostic factors. Conclusions : The results of our study were comparable with those previously reported. To Improve treatment outcome, various modifications, Including radiation dose escalation through newer radiation therapy techniques and use of effective chemotherapy regimen, should be further Investigated. Investigated. Also Furthermore, the application of Individualized treatment strategy based on 4he patient's prognostic factors might be needed.

목적 : 두개 내 다형성아교모세포종 환자의 방사선치료 후 생존율을 조사하고 그 예후 인자의 중요성을 알아보고자 하였다. 대상 및 방법: 1994년부터 2003년까지 삼성서울병원에서 병리학적으로 다형성아교모세포종으로 확진된 환자 중 근치적 목적으로 방사선치료를 시행한 120명을 대상으로 분석하였다. 남자는 64명(53$\%$), 여자는 56명(47$\%$)이었으며, 20례(17$\%$)의 종양은 다발성이었다. 수술은 육안적 완전 절제, 부분 절제 및 조직검사를 각각 22례(18$\%$), 59례(58$\%$), 29례(24$\%$)에서 시행하였고, 방사선치료는 4$\~$10 WV 선형가속기를 이용하여 54$\~$72Gy (중앙값 60 Gy)를 조사하였다. 대상 환자의 추적관찰기간은 2개월에서 62개월(중앙값 12개월)이었다. 결과 : 전체 환자군의 1년 및 2년 생존율은 52$\%$와 14$\%$이었으며, 중앙생존기간은 13개월이었다. 예후 인자에 따른 1년 생존율은 50세 미만은 64$\%$, 50세 이상은 41$\%$ (p<0.01), 수술 전 활동도가 ECOG 0 혹은 1인 경우 는 57$\%$, 2 이상은 44$\%$ (p=0.03)였다. 두개 내 병변 수에 따른 1년 생존율은 단일병변은 57$\%$, 다발성 병변은 23$\%$ (p=0.02)이었으며, 절제정도에 따른 생존율은 육안적 완전 절제, 부분 절제, 조직검사만 시행한 경우에 각각 67$\%$, 48$\%$, 47$\%$ (p=0.04)였다. 다변량 분석에 따른 예후인자로는 여자(p<0.01), 50세 미만(p<0.01), 활동도가 ECOG 0 혹은 1 (p=0.05), 육안적 완전절제(p=0.05)가 좋은 예후 인자이었다 결론 : 근치적 목적으로 방사선치료를 시행한 두개 내 다형성아교모세포종 환자의 중앙생존기간은 13개월로 기존의 문헌보고와 비슷한 수준이었다. 치료성적의 향상을 위하여 다양한 방사선치료 기술의 적용을 통한 방사선량의 증가와 효과적인 항암화학요법 약제의 개발 및 사용 등의 연구가 필요하고, 환자의 예후인자에 따라 개별화된 치료방법이 적용되어야 할 것으로 판단된다

Keywords

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