目的：比較一日一次或一日兩次之放射治療未合併化學治療對於惡性神經膠質瘤之療效。材料與方法：對於 48 位未接受化學治療僅單純接受射治療之惡性神經膠質瘤患者，進行回溯性研究。放射治療分為一日一次（1.8~2 Gy ／日）或一日兩次（1.2~1.5 Gy 兩次／日）。其中 8位僅接受組織切片而無腫瘤切除，28 位接受局部切除而 12 位接受完全切除。存活率分析使用
Kaplan and Meier 方法來計算。和存活率相關的單變項分析採用 log rank test ，而多變項分析則利用 Cox regression models 來進行。結果：存活中位月數為 13 個月。2 位病人達到完全反應，22 位達部分反應，另外的24 位則是無反應或病情惡化。一日兩次並未有較好的存活中位月數（13 vs. 16.73 個月，p= 0.439）。在單變項及多變項分析中僅發現年齡大於 50 歲為有意義的較差的預後因子。腫瘤範圍超過一葉、無法近全腫瘤切除、及生物等效劑量未達 72 GyE 有較差之預後但未達統計意義。結論：在本研究中並未發現一日兩次的放射治療有較好的治療成果。將來仍需要更大規模的研究以確認惡性神經膠質瘤最適合的治療方式。

Aims and Background : To review if hyperfractionated radiotherapy provides better tumor control over standard radiotherapy for malignant glioma without chemotherapy.Methods : The records of 48 patients with glioblastoma multiforme or anaplastic astrocytoma treated with hyperfractionated/standard radiotherapy were reviewed for survival and prognostic factors analyses. The radiation schedule consisted of standard
fractionation (1.8~2 Gy/day) or hyperfractionated fractionation (1.2~1.5 Gy twice/day with at least 6 hours interval), depending on the preference of different physicians.None of them received chemotherapy. Eight patients underwent biopsy only,and 28 patients underwent subtotal resection. The rest 12 patients had gross tumor resection. Survival rates were estimated using the method of Kaplan and Meier. In univariate analyses of survival time, the different variables were compared using the
log rank test. Within the framework of Cox regression models,multivariate analysis was performed to differentiate the relationships between variables and their relevance to the survival.Results : No patient was lost to follow-up. Median survival was 13 months (range,1-158 months). Two patients had complete response after radiotherapy. Twenty-two
had partial response. The other 24 had stable disease or progression. The hyperfractionated radiotherapy group didn’t show any benefit on survival (13 vs. 16.733 months,p= 0.439). Age older than 50 years showed worse prognosis in both univariate and multivariate analyses. Tumor involvement more than one lobe, grossly total resection not achieved, and biologically equivalent dose (assuming α/β ratio= 10) (BED10) less
than 72 GyE had trends associating with worse prognosis, which were not statistically significant.Conclusion : In our study, patients didn’t benefit from hyperfractionated radiotherapy.Due to small patient number, further investigation is warranted to evaluate the benefit and toxicity of hyperfractionated radiotherapy.