目的：分析惡性星狀細胞瘤術後放療或合併放化療治療結果及預後因子。材料及方法：從2002 年4 月至2007 年12 月，共有35 位新診斷惡性星狀細胞瘤及多形惡性神經膠質瘤的病人接受手術切除，術後接受放射治療或同步放化療。放射治療使用三度空間順形放射治療（3DCRT），於六週內給予60 Gy 。我們使用影像結合的技術，結合術前核磁共振及電腦斷層定位的影像，決定治療區域的範圍。化學治療使用帝盟多，在同步放化療的過程，劑量為每天75 mg/m2，至少使用49 天。放療後化療，28 天為一個療程，每個療程前5 天接受化療，劑量為每天150-200 mg/m2，至少6 個療程。追蹤和存活時間的定義為切片診斷的日期到死亡的日期。存活率曲線以Kaplan-Meier 方法繪製。結果：平均追蹤時間為19.1 個月。追蹤期間內，共10 位病人存活，25 位病人死亡。所有病人的平均存活率為19.1 個月。三年存活率，在放療這組為14% ，放化療這組為 43%（p 值=
0.002）。三年無復發存活率，在放療這組為10.6% ，放化療這組為13.9%（p 值= 0.54）。惡性星狀細胞瘤的病人，存活率在放療這組為8.7% ，放化療這組為 67.9%（p 值= 0.001）。多形
惡性神經膠質瘤的病人，存活率在放療這組為16.3% ，放化療這組為23.7%（p 值= 0.261）。
放射治療照野內的復發為主要的復發型態。所有35 位病人中，有22 位病人發生照野內復發（62.8%）。所有的病人皆完成放射治療。30 位病人（86%）產生Grade I 中樞神經毒性；5 位病人（14%）產生Grade II 中樞神經毒性。21 位接受化療的病人中，18 位病人在化療過程中並沒有任何副作用產生。結論：對於新診斷的惡性星狀細胞瘤及多形惡性神經膠質瘤的病人手術切除後，術後接受同步放化療有統計學上存活率的幫助而僅有可接受之副作用。

Purpose : To analyze the treatment results of malignant astrocytoma after radiotherapy alone or concurrent chemoradiotherapy plus adjuvant chemotherapy in TSGH. Methods and Materials : From April 2002 to December 2007, we identified 35 patients with documented, histologically confirmed, previously untreated glioblastoma multiforme (GBM) or anaplastic astrocytoma (AA). They were treated with surgical resection followed by radiotherapy alone or chemoradiotherapy in our hospital. A total of 60 Gy was given in 6 weeks with 3D conformal RT (3D-CRT). Fusion of planning CT with MRI was routinely used to assist target delineation. We used concomitant temozolomide (75 mg/m2 daily up to 49 days) followed by up to six cycles of adjuvant temozolomide (150 to 200 mg/m2 daily for five days, every 28 days). Follow-up and survival times were calculated from the date of diagnosis to the date of last contact or death. Disease-free survival (DFS) and overall survival (OS) were computed by Kaplan–Meier methods. Results : The median follow-up was 19.1 months. At the time of analysis, 10 patients were alive, 25 patients had died. The median survival rate was 19.1 months for all patients. The 3-year overall survival rates were 14% and 43% in radiotherapy alone arm and CCRT arm, respectively. (p= 0.002). The 3-year progression-free survival rates were 10.6% and 13.9% in radiotherapy alone and CCRT arm, respectively. (p= 0.54). In the AA group, the overall survival rates were 8.7% and 67.9% in radiotherapy alone arm and CCRT arm, respectively. (p= 0.001). In the GBM group, the overall survival rates were 16.3% and 23.7% in radiotherapy alone and CCRT arm, respectively. (p= 0.261). In-field failure was the major cause of failure, among 35 patients, 22 (62.8%) patients had in-field failure. All patients completed radiotherapy courses. Thirty (86%) patients had grade 1 CNS toxicity and 5 (14%) patients had grade 2 CNS toxicity. Among 21 patients who received temozolomide, 18 patients had no obvious side effects during and after chemotherapy. Conclusions : Addition of adjuvant chemotherapy with temozolomide to radiotherapy for patients with newly diagnosed AA and GBM has statistically significant survival benefit especially for patients of AA with tolerable toxicity.