单独X刀治疗多发脑转移瘤133例疗效分析  

Therapeutic efficacy of multiple brain matastases treatment with linear accelerator radiosurgery alone

作　　者：陈苏[1] 王如密[1] 王守森[1] 王剑[2] 高进喜[1] 魏梁锋[1] 

机构地区：[1]福州总医院神经外科 [2]福建医科大学公共卫生学院

出　　处：《福州总医院学报》2009年第1期43-45,共3页Journal of Fuzhou General Hospital

摘　　要：目的:评估单独采用X刀放射外科治疗多发脑转移瘤的疗效及其影响因素。方法:133例多发脑转移瘤病人单独接受X刀放射外科治疗,不合并全脑放射治疗。原发恶性肿瘤包括非小细胞肺癌、乳腺癌及其它。平均脑转移瘤的个数为4.4个(2～12个),平均肿瘤总体积为16.2cm3(1.0cm3～53.0cm3),平均边缘剂量为16.7Gy,平均随访时间7.0月。结果:中位生存时间为9.0月。COX回归分析发现:肿瘤总体积、PRA等级、边缘剂量为显著预后因子;脑转移瘤的个数、年龄、中心剂量没有统计显著性。结论:肿瘤总体积、RPA等级为多发颅内转移瘤显著预后因子。肿瘤总体积应该作为放射外科的选择标准,而不是转移瘤的个数。多发脑转移瘤单独采用X刀放射外科治疗可以获得满意的疗效,而是否有必要全脑放射治疗,值得商榷。Objective： To evaluate the therapeutic efficacy and its affecting factors of multiple brain matastases treatment with linear accelerator radiosurgery alone. Method： One hundred and thirty- three patients with primary malignancies, including non- smaLl - ceU lung carcinoma, breast carcinoma and others underwentlinear accelerator radiostgrgery alone for multiple brain metastases. The mean number of brain metastases was 4.4 （range 2--12） with a mean total treatment volume of 16.2cm^3 （range 1.0--53.0 cm^3） . Linear accelerator radiosurgery was as sole management, not combined with whole brain radiotherapy （WBRT） . The mean marginal radiosurgery dose was 16.7 Gy. The mean follow - up was 7.0 months. Results： The median overall survival after linear accelerator radiosurgery for all patients was 9 months. COX congreasion analysis revealed that total tumor volume, RPA clssification and marginal doses were significant prognostic factors （p〈（0.05）, and the number of metastases, ages and center dose were not （p〉0.05） . Conclusion： Linear accelerator radiosurgery alone seems to provide survival benefit for patients with multiple brain metastases. Total tumor volume rather than the number of metastases was the most significant predictor of survival, and should be considered in the choice of appropriate radiosurgery.

关 键 词：X刀 放射外科 多发脑转移瘤 COX回归分析 全脑放射治疗 

分 类 号：R739.41[医药卫生—肿瘤] R512.63[医药卫生—临床医学]