立体定向放疗在肺癌脑转移瘤治疗中的作用研究  

Study on the Stereotactic radiotherapy in lung cancer patients with brain metastases

作　　者：万跃[1] 谭兵[1] 蒋勇[1] 黄锣[1] 王颖[1] 

机构地区：[1]重庆市肿瘤医院放疗科,重庆400041

出　　处：《现代预防医学》2012年第16期4338-4340,共3页Modern Preventive Medicine

摘　　要：目的对比研究全脑放疗(WBRT)联合立体定向放射治疗(SRT)与联合三维适形放射治疗(3D-CRT)局部肿瘤加量治疗肺癌脑转移的疗效与耐受性。方法 2009～2010年所收治92例肺癌脑转移瘤患者(脑转移病灶≤3个),随机分组WBRT加3D-CRT:46例,WBRT加SRT:46例。评价指标为中位生存期(MST)和放疗毒性,全组患者中位随访时间12月,随访率100%。结果全组中位生存期为8.9个月,其中3D-CRT组8.6个月、SRT组9.4月(χ2=0.22,P﹥0.05)。放疗后3个月肿瘤局部控制率分别为71.7%﹑63%。结论 SRT是肺癌脑转移瘤患者的一种有效治疗手段,对脑转移瘤≤3个的患者,3D-CRT与SRT局部肿瘤加量生存期差异无统计学意义,放疗不良反应亦无明显差异,但SRT治疗2次比3D-CRT治疗13-15次在放疗时间上占优势。OBJECTIVE To evaluate the efficacy and tolerability of WBRT （Whole brain radiotherapy） with SRT or 3D-CRT （3 dimensional conformal rediation therapy） boost in treatment of brain metastasis of lung cancer patients. METHODS 92 pa- tients from 2009-2010 （brain metastasis ≤3） were randomly divided into two groups. 46 patients was received WBRT ＋ SRT, and the others received WBRT ＋ 3D-CRT. The results was evaluated by median survival rate and toxicity effect, all the patients were followed up for 12 months. RESULTS The median survival time of whole patients was 8.9 months, and was 8.6 months in 3D-CRT group and 9.4 months in SRT group （X2= 0.22, P 〉 0.05）. The local control rate was 71.7% and 63% for 3D-CRT and SRT within 3 months, respectively. CONCLUSION SRT was a efficacious methods in treatment of brain metastasis from lung cancer, especially for those with ≤3 brain metastasis. There was no difference between SRT and 3D-CRT boost in terms of survival time and toxicity, but SRT possessed the more tolerance and shorter time.

关 键 词：立体定向放疗 肺癌脑转移 恶性肿瘤 

分 类 号：R734.2[医药卫生—肿瘤]