目的以普通放疗为对照，分析三维适形放疗对不同病理分级的脑胶质瘤的疗效，比较两种放疗剂量学与临床疗效间的关系。方法选取97例脑胶质瘤术后放疗患者为研究对象，并根据放疗方式分为普放组与适形组。分析两种放疗模式对相同病理分级患者预后的影响，比较三维适形放疗与普通放疗的剂量学差异。结果低级别胶质瘤（I＋ II级）三维适形和常规放疗的总生存率比较差异无统计学意义（P＞0．05）；而高级别胶质瘤（III＋IV级）三维适形放疗患者的3年生存率显著高于常规放疗患者（P＜0．05）。适形组高颅压及放射性脑损伤发生率显著低于普放组（P＜0．05）。适形组靶区（包括PTV1和PTV2）Dmean、CI均显著高于普放组（P＜0．05）。结论三维适形放疗靶区内剂量及适形度显著优于普通放射治疗，高级别脑胶质瘤患者获得更长的生存时间，三维适形放疗不良反应更低，在一定程度上提高了患者生存质量。%Objective In contrast to conventional radiotherapy ,analyze the dosimetry and prognosis of 3D conformal radiothera-py in the treatment of gliomas with different pathological stages .Methods 97 patients with gliomas were selected ,and divided into two groups as conventional radiotherapy group (CR group) and 3D conformal radiotherapy group(3D group) .analyzed the influence of different radiotherapy to the gliomas in the same pathological stage .Compared the dosimetry differences between these two radio-therapies .Results There was no obvious differences in 3 year survival rate between CR group and 3D group at low grade gliomas . But 3D group had better 3 year survival rate than CR group at high grade gliomas .And 3D group had lower rate of relevant sequel after radiotherapy .3D group had higher conformal index (CI) and average dosage of radiation than CR group .Conclusion 3D radio-therapy has better dosimetry and conformal index than conventional radiotherapy ,especially has better prognosis in high grade glio-mas and lower rate of relevant sequel after radiotherapy .
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