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The Role of Radiation Therapy in the Treatment of Intracranial Glioma : Retrospective Analysis of 96 Cases

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±è¿¬½Ç ( Kim Yeon-Sil ) - °¡Å縯´ëÇб³ Àǰú´ëÇÐ °­³²¼º¸ðº´¿ø Ä¡·á¹æ»ç¼±°ú

°­±â¹® ( Kang Ki-Mun ) - °¡Å縯´ëÇб³ Àǰú´ëÇÐ °­³²¼º¸ðº´¿ø Ä¡·á¹æ»ç¼±°ú
ÃÖº´¿Á ( Choi Byung-Ock ) - °¡Å縯´ëÇб³ Àǰú´ëÇÐ °­³²¼º¸ðº´¿ø Ä¡·á¹æ»ç¼±°ú
À±¼¼Ã¶ ( Yoon Sei-Chul ) - °¡Å縯´ëÇб³ Àǰú´ëÇÐ °­³²¼º¸ðº´¿ø Ä¡·á¹æ»ç¼±°ú
½Å°æ¼· ( Shinn Kyung-Sub ) - °¡Å縯´ëÇб³ Àǰú´ëÇÐ °­³²¼º¸ðº´¿ø Ä¡·á¹æ»ç¼±°ú
°­Áرâ ( Kang Jun-Gi ) - °¡Å縯´ëÇб³ Àǰú´ëÇÐ °­³²¼º¸ðº´¿ø ½Å°æ¿Ü°úÇб³½Ç

Abstract

1983³â 3¿ùºÎÅÍ 1989³â 12¿ù±îÁö °¡Å縯Àǰú´ëÇÐ °­³²¼º¸ðº´¿ø Ä¡·á¹æ»ç¼±°ú¿¡¼­ ³ú±³Á¾À¸·Î ¹æ»ç¼±Ä¡·á¸¦ ¹ÞÀº ȯÀÚ 96¸íÀ» ´ë»óÀ¸·Î ¹æ»ç¼±Ä¡·á ¼ºÀû ¹× »ýÁ¸·ü¿¡ ¿µÇâÀ» ¹ÌÄ¡´Â ¿¹ÈÄÀÎÀÚµéÀÇ ÈÄÇâÀû ºÐ¼®Á¶»ç¸¦ ½Ç½ÃÇÏ¿´´Ù. ´ë»óȯÀÚÀÇ ¿¬·ÉºÐÆ÷´Â 3¼¼¿¡¼­ 59¼¼¿´À¸¸ç (Áß¾Ó°ª 42¼¼), ³²³àºñ´Â 60:36À̾ú°í, ÀÓ»óÁÖÁß»óÀº µÎÅë ¹×(67%) ¿îµ¿½Å°æ ¸¶ºñ(54%)¿´´Ù. Á¶Á÷ÇÐÀû Áø´Ü¹æ¹ý ¹× ¼ö¼úÀº »ý°Ë 21¸í(22%), ºÎºÐÀýÁ¦ 21¸í(22%), ¾ÆÀüÀýÁ¦ 29¸í(30%), ÀüÀýÁ¦ 14¸í(15%)ÀÌ¿´°í, ³ú°£À» ħ½ÀÇÑ È¯ÀÚ 12¸í Áß 11¸íÀº Á¶Á÷°Ë»ç¸¦ ½ÃÇàÇÏÁö ¾Ê¾Ò´Ù. Á¶Á÷ÇÐÀû ºÐ·ù´Â ¼º»ó¼¼Æ÷Á¾ÀÌ 64¸í(75%)À¸·Î °¡Àå ¸¹¾Ò°í, ȸµ¹±â±³¼¼Æ÷Á¾ÀÌ 17¸í(20%), È¥ÇÕÇüÀÌ 4¸í(5%)¿´´Ù. Á¶Á÷ÇÐÀû µî±Þ¿¡ µû¸¥ ±¸ºÐÀº 49¸íÀÌ grade ¥°,¥±Á¾¾ç(58%)À̾úÀ¸¸ç, 36¸íÀÌ grade ¥², ¥³Á¾¾ç(42%)À̾ú´Ù. Àüü 96¸í Áß 64¸í(67%)ÀÌ ¼ö¼ú°ú ¹æ»ç¼± Ä¡·á¸¦ º´ÇàÇÏ¿´°í, 32¸í(33%)ÀÌ ¹æ»ç¼±´Üµ¶ ¿ä¹ýÀ¸·Î Ä¡·áÇÏ¿´À¸¸ç, 25¸í(26%)ÀÇ È¯ÀÚ¿¡¼­ È­Çпä¹ýÀ» º´ÇàÇÏ¿´´Ù.
ÀüüȯÀÚÀÇ Æò±Õ »ýÁ¸±â°£Àº 53°³¿ùÀ̾ú°í, 2³â ¹× 5³â »ýÁ¸·üÀÌ °¢°¢ 69%, 49%À̾ú´Ù. Á¶Á÷ÇÐÀû µî±Þ¿¡ ÀÇÇÑ »ýÁ¸·üÀº grade ¥° Á¾¾çÀÇ 5³â »ýÁ¸·üÀÌ 70%¾ú°í, grade ¥±,¥²,¥³ Á¾¾çÀÌ °¢°¢ 58%, 28%, 15% ¿´´Ù.
¿¬·É, Á¶Á÷ÇÐÀû µî±Þ ¹× ºÐ·ù, Karnofsky performance status(KPS), ħ½ÀºÎÀ§, ¼ö¼úÀû Á¦°Å ¿©ºÎ ¹× Á¦°ÅÁ¤µµ, ¹æ»ç¼±Ä¡·á¼±·®, ¹æ»ç¼±Á¶»ç¾ß, È­Çпä¹ý º´Çà ¿©ºÎ¿¡ µû¶ó »ýÁ¸·üÀ» ºÐ¼®ÇÑ °á°ú ¿¬·É(p=0.0121) ,KPS(p=0.0002) ,Á¶Á÷ÇÐÀû µî±Þ(P=0.0001) , ¼ö¼úÀû Á¦°Å (p=0.0240)°¡ À¯ÀÇÇÑ ¿¹ÈÄÀÎÀÚ·Î ºÐ¼®µÇ¾úÀ¸¸ç, Åë°èÇÐÀûÀ¸·Î À¯ÀÇÇÏÁö´Â ¾Ê¾ÒÁö¸¸ õ¸·ÇϺ´¼Ò°¡ õ¸·»óºÎ º´¼Ò¿¡ ºñÇØ, ºÎºÐÁ¶»ç°¡ Àü³úÁ¶»ç¿¡ ºñÇØ ³ôÀº »ýÁ¸·üÀ» º¸ÀÌ´Â ¸Å°³º¯¼ö·Î ºÐ¼®µÇ¾ú´Ù.

Between March 1983 and December 1989, ninety-six patients with intracranial glioma were treated in the Department of Therapeutic Radiology, Kangnam St. Mary Hospital, Catholic University Medical College. We retrospectively reviewed each case to evaluate variable factors influencing the treatment results and to develop an optimal therapy Policy. Median follow-up is 57 months(range:31¡­133 months). Of the 96 patients, 60(63%) were males and 36(37%) were females. Ages ranged from 3 to 69 years (median 42 years). The most common presenting symtoms were headache(67%) followed by cerebral motor and sensory discrepancy(54%), nausea and vomiting(34%), seizure (19%), mental change(10%) and memory and calculation impairment(8%). Eighty five(88.5%) patients all, except 11(11.5%) brain stem lesions, were biopsy proven intracranial glioma. The distribution by histologic type was 64 astrocytomas(75%), 4 mixed oligoastrocytomas(5%), and 17 oligodendrogliomas(20%). Fourty nine patients (58%) were grade ¥°,¥± histology and 36 (42%) patients were grade ¥², ¥³ histology. Of the 96 patients, 64(67%) recieved postoperative RT and 32(33%) were treated with primary radiotherapy. Gross total resection was performed in 14(16%) patients, subtotal resection in 29(34%), partial resection in 21(25%), and biopsy only in 21(25%). Median survival time was 53 months(range 2¡­133 months), and 2- and, 5-year survival rate were 69%, 49% respectively. 5-year survival rate by histologic grade was grade¥°, 70%, grade¥±, 58%, grade ¥², 28%, and grade ¥³, 15%.
Multivariated analysis demonstrate that age at diagnosis (p=0.121), Karnofsky performance Status(KPS)(p=0.0002), histologic grade(p=0.0001), postoperative radiation therapy(p=0.0278), surgical extent(p=0.024), cerebellar location of tumor(p=0.0095) were significant prognostic factors influencing on survival.

Ű¿öµå

Intracranial glioma;Radiation therapy;Prognostic factors
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