脑转移瘤神经外科、放射神经外科合作治疗的回顾分析  

Treatment of Brain Metastases with Combined Neurosurgery and Radioneurosurgery

作　　者：张宗平 曾火勇 谭鑫 

机构地区：[1]湛江肿瘤医院,广东湛江524002

出　　处：《中国神经肿瘤杂志》2010年第3期160-162,共3页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:脑转移癌的治疗常需多学科合作科学处理。本研究总结神经外科、放射神经外科合作诊治脑转移瘤的经验。方法:回顾性总结神经外科和放射神经外科合作处理98例脑转移瘤的临床资料,其中,原发肿瘤为肺癌67例,乳腺癌20例,消化道恶性肿瘤5例,恶性黑色素瘤2例,原发灶不明4例;其中手术证实为腺癌3例,鳞癌1例。结果:脑转移瘤单发41例,多发57例;手术切除+全脑放疗36例,中位生存期56周;姑息手术+全脑放疗11例,中位生存期46周;姑息手术+立体定向+全脑放疗9例,中位生存期49周;立体定向+全脑放疗42例,中位生存期52周。无手术死亡和严重并发症。结论:神经外科医生和放射治疗科医生密切合作,能提高脑转移瘤的治疗效果,减少误诊、误治。BACKGROUND OBJECTIVE： The treatment of brain metastases often requires a multidisciplinary cooperation. In this study, we summarized the cooperation experience by neurosurgery, radiation therapy and radiosurgery in diagnosis and treatment of brain metastases. METHODS： A retrospective review of 98 cases with brain metastases managed by neurosurgery, radiation therapy and radiosurgery was performed. The primary disease was lung cancer in 67 cases, breast cancer in 20 cases, gastrointestinal malignancies in 5 cases, malignant melanoma in 2 cases, and other cancer in 4 cases, respectively. RESULTS： Surgical resection and whole-brain radiotherapy were performed in 36 cases with a median survival of 56 weeks. Palliative surgery and whole-brain radiotherapy were used in 11 cases with a median survival of 46 weeks. Palliative surgery and stereotactic plus wholebrain radiotherapy were undergone in 9 cases with a median survival 49 weeks. Stereotactic plus whole-brain radiotherapy was employed in 42 cases with a median survival of 52 weeks. Single brain metastasis was found in 41 cases and multiple metastases were found in 57 cases. No operation-related mortality and severe complications were observed. CONCLUSION： Treatment of brain metastases with the combination of neurosurgery, radiation therapy and radiosurgery can achieve a better prognosis, reduce misdiagnosis and wrong treatment.

关 键 词：神经外科 放射神经外科 脑转移瘤 学科合作 

分 类 号：R739.41[医药卫生—肿瘤]