X线立体定向放射外科治疗颅内转移瘤520例临床分析  

Stereotactic Radiosurgery by X-knife for the Treatment of Brain Metastatic Tumors:Analysis of 520 Cases

作　　者：孟庆勇[1] 徐培坤[1] 陈小妹[1] 陈先平[1] 董东[1] 

机构地区：[1]安徽医科大学第一附属医院X刀中心,合肥230022

出　　处：《中国微创外科杂志》2009年第8期682-683,690,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的总结脑转移瘤X线立体定向放射外科(X刀)治疗的临床疗效及生存期。方法回顾性分析我院1996年3月～2008年3月X刀治疗的有完整随访结果共520例颅内转移瘤资料,其中单发转移灶336例,多发转移灶184例(2个病灶51例,3～5个病灶63例,6～10个病灶70例)。病灶直径5～35mm,平均16.4mm。治疗时平均中心剂量22Gy(20～25Gy),周边剂量12Gy(10～14Gy),覆盖病灶体积80%以上。结果520例随访8～36个月,平均20个月。术后6个月复查的CT和MRI显示,完全缓解218例(41.9%),部分缓解182例(35.0%),无变化78例(15.0%),进展42例(8.1%),病灶总控制率91.9%(478/520)。生存时间达6个月者共442例(85.0%),生存时间达12个月者共354例(68.1%),1年、3年生存率分别为40%、5.5%,中位生存期为12.6月。结论X刀治疗脑转移瘤临床疗效肯定,能够提高患者的生活质量和相对延长生存期。Objective To explore the efficacy and postoperative survival times of stereotactic radiosurgery by X-knife in the treatment of brain metastatic tumors. Methods Between March 1996 and March 2008, 520 patients with brain metastatic tumors were treated in our hospital by stereotactic radiosurgery using X-knife. Among the cases, 336 had single metastatic lesions, and 184 presented with multifocal tumors （2 lesions in 51 patients, 3 -5 lesions in 63, and 6 - 10 lesions in 70）. The tumors sized 5 to 35 mm in diameter with a mean of 16.4 mm. Stereotactie radiosurgery was carried out in the cases with a mean central dose of 22 Gy （20 to 25 Gy） , and mean marginal close of 12 Gy （ 10 to 14 Gy）. Over 80% of the lesions were encircled with the dosage. Results The 520 patients were followed up for 8 to 36 months （mean, 20 months）. CT and MRI performed in the 6th months postoperation showed complete response in 218 patients （41.9%） , partial response in 182 （35.0%） , no response in 78 （ 15.0% ） , and progressed disease in 42 （8.1%）. The overall control rate of the tumors were 91.9% （478/520）. In this series, the 6-months survival rate was 85.0% （442/520）, 12-month survival rate was 68.1% （354/520）, and the 1-year and 3-year survival rates were 40% and 5.5% respectively. The medium survival time was 12.6 months. Conclusions Stereotactic radiosurgery is an effective method for brain metastatic tumors. It can improve the life quality and survival time of the patients.

关 键 词：X线立体定向放射外科 放射治疗 脑 转移瘤 

分 类 号：R739.41[医药卫生—肿瘤]