X线立体定向放射治疗脑转移瘤疗效分析  

Analysis of result for brain metastases of X-ray stereotactic radiotherapy

作　　者：孙曙光[1] 刘菲[1] 尚峰[1] 王鹏[1] 

机构地区：[1]解放军94医院放疗科,江西南昌330002

出　　处：《中华肿瘤防治杂志》2006年第17期1343-1344,共2页Chinese Journal of Cancer Prevention and Treatment

摘　　要：为了探讨X线立体定向放射治疗加全脑放疗的疗效，在四种预后因素（年龄、疗前KPS评分、有无远外转移及转移灶数目）相同或相似的条件下，配对选择两组各43例脑转移瘤患者分成X线立体定向放射治疗（SRT）加全脑放疗组（研究组）和单纯SRT治疗组（对照组）。研究组采用全脑放疗30～40Gy／3．5～4．5周，SRT处方剂量为15～32Gy，SRT前行全脑放疗17例。后行全脑放疗26例。对照组采用单纯SRT处方剂量18～32Gy。结果研究组复发率11．6％（5／43），中位生存时间12．7个月，与对照组的44．2％（19／43）和7．8个月比较差异有统计学意义（χ^2=10．03，P〈0．01；t=2．26，P〈0．05）；研究组局部控制率（CR＋PR）97．7％（42／43），1年生存率67．4％（29／43），1年死亡率32．6％（14／43），与对照组的93％（40／43）、51.1％（22／43）和48．9％（21／43）比较差异无统计学意义（P〉0．05）。初步研究结果提示，SRT加全脑放疗在控制肿瘤复发和延长中位生存时间均明显优于单纯SRT。To analyze the effect of stereotactic Radiotherapy（SRT） plus whole brain radiotherapy （WBRT） on brain metastases. Comparison was made in 43 such patients treated by SRT plus WBRT group （study group）and 43 treated by SRT alone group （control group）. Patients were matched paired according to the following criteria：age, Karnofsky performance scale （KPS） before treatment, extent of systemic concer and number of brain metastasis. In the study group, WBRT were given with the dose of 30-40 Gy/3.5-4.5 w,SRT were given with in dose of 15-32 Gy. In the control group. SRT were given with in dose of 18-32 Gy. The recurrent rate and median survival period were 11.6% （5/43） and 12.7 months in the study group, as compared with 44.2%（19/43） and 6.3 months with difference significant （χ^2 = 10.03, P〈0.01 and t= 2.26, P〈0.05）. local control （CR＋ PR）, one year survival rate and mortality were 97.7%（42/43）, 67.4%（29/43）, 32.6%（14/43） in the study group and 93% （40/43）, 51.1%（22/43）, 48. 9%（21/43） in the control group with no significant diffirence between the two group （χ^2= 1.05 and 2.36,P〉0.05 ）. Conclusion SRT plus WBRT is superior to SRT alone for brain metastases in controling recurrence and prolonging median survival period.

关 键 词：脑肿瘤/放射疗法 脑肿瘤/继发性 立体定位技术 

分 类 号：R739.41[医药卫生—肿瘤]