The Effect of Radiation Therapy on Oligodendrogliomas

국문 초록 (Abstract)

가톨릭의대 방사선치료실에서는 1983년 4월부터 1989년 4월 사이 6년 동안에 회돌기교종환자 21예를 외부방사선 치료하였다. 전예에 대하여, 연령 및 발병부위별 빈도와 임상증상과 CT 소견 그리고 추적 가능하였던 20예의 생존율에 관한 후향적 분석을 하여 다음과 같은 성적을 얻었다. 1. 전예는 원발성 뇌종양으로 방사선치료 하였던 환자 (246예)의 약 8%의 빈도를 보였으며, 연령 분포는 5~62세(중앙값 38세)이고, 남녀의 비는 13:8이었다. 2. 임상 주 증상은 두통 18예(86%), 뇌운동신경마비 12예(57%), 오심구토 7예 (33%), 경련 5예 (24%)등 순을 보였다. 3. 발병부위는 전두엽 10예 (48%), 두정엽 10예 (48%), 측두엽 7예 (33%), 후두엽 2예 (10%) 그리고 뇌간 및 소뇌가 각각 1예 (5%)씩 이었다. 4. 조직학적 진단은 정위다방향 조직생검이 3예(14%), 종양의 수술적 제거 (부분 전체제거)에 의함이 18예(86%)이었다. 전예에서 전뇌 및 소부위에 3960~6480cGy/5~8주 외부방사선 치료를 하였고, 6예(29%)에서는 항암약물 치료도 병행하였다. 5. CT음영은 저, 고, 혼합 및 등가음영이 각각 13(62%), 3(14%), 3(14%), 2(10%), 예씩 이었고, 낭성종괴 7예(33%), 괴사 및 출혈성 종괴가 각각 1예(5%)씩 이었다. 석회와 음영은 14예(67%)에서 관찰되었으며, 조영증강 유무는 9:12로 나타났다. 6. 평균생존기간은 38개월이었다.

다국어 초록 (Multilingual Abstract)

From April, 1983 through April, 1989, we have treated histologically proven 21 patients with oligodendroglioma using 6 MV linear accelerator at the Division of Radiation Therapy, Kangnam St. Mary's Hospital Catholic University Medical College. These are 8% of the irradiated 246 primary brain tumors during the same period. To investigate influencing factors on the survival of irradiated 21 patients with oligodendrog-lioma, we analyzed the cerebral location of the involvements, initial symptoms, CT findings and survival rates, retrospectively. One case was lost to follow up and excluded from survival data. Of the 21 patients, thirteen were male and 8 female. Ages raged from 5 to 68 years with a median age of 38 years. Radiation doses varied from 3960 cGy to 6480 cGy and were given for 5 to 8 weeks. All but one were supratentorial. The involvement of the frontal and parietal lobes were 10 (48%) patients in each and temporal lobe in 8 (38.1%) Histological diagnosis was made by stereotactic biopsy in 3 and postoperatively in 18. The type of surgery was divided into partial, subtotal and total resection in 7, 9 and 2 cases respectively. In 6 cases, chemotherapy was also tried during or after radiation therapy. Major presenting symptoms were headache, cerebral motor, nausea & vomiting and epilepsy in 18, 12, 7 and 5 respectively in decreasing order. In CT analysis, low density (62%), cystic mass (33%), calcifica-tion (66%) and positive contrast enhancement (42.8%) were observed as the highest frequency. Mean survival duration after radiation therapy was 38 months (K-M methods). We could not achieve statistically significant factors influencing on the survival rate after radiation therapy for oligodendrogliomas by one or two tail test.