非小细胞肺癌单发脑转移瘤放射治疗方法的研究  

Research on Patients with Single Brain Metastases from Non-small Cell Lung Cancer Treated with Radiotherapy

作　　者：李宝生[1] 于金明[1] 王立英[1] 翟利民[1] 周涛[1] 尹勇[1] 王亚彬[1] 

机构地区：[1]山东省肿瘤医院放疗科,山东济南250117

出　　处：《肿瘤防治杂志》2002年第4期410-413,共4页China Journal of Cancer Prevention and Treatment

摘　　要：目的 :确定立体定向放射外科治疗非小细胞肺癌单发脑转移瘤是否需合并全脑照射。方法 :4 1例肺癌单发脑转移的患者前瞻性的分为单纯立体定向放射外科组和全脑照射合并立体定向放射外科组。全脑照射结合立体定向放射外科治疗者 ,先行全脑放疗 ,全脑放疗结束后休息 7～ 14d ,再行立体定向放射外科治疗。观察指标包括总生存时间、局部无复发生存时间、颅脑无新病灶生存时间、局部控制率、KPS的改善及死亡原因等。结果 :单纯立体定向放射外科和全脑照射合并立体定向放射外科治疗后的中位生存时间分别为 9 3个月和 10 6个月 ,中位局部无复发生存时间分别为 6 9个月和 8 6个月 ,中位颅脑无新病灶生存时间分别为 6 7个月和 8 6个月 ,局部控制率分别为 87 0 %和 88 9% ,KPS的改善率分别为 82 6 %和 88 9% ,死于脑转移瘤复发或新转移灶者分别占 5 0 0 %和 2 8 3%。单因素分析显示单纯立体定向放射外科和全脑照射合并立体定向放射外科间 ,除颅脑无新病灶生存有显著性差异外 ,其他各项指标差异均无显著性。然而 ,单纯立体定向放射外科治疗后出现颅脑新病灶的 6例患者 ,予以挽救性治疗 ,均得到较好地控制。结论 :在非小细胞肺癌单发脑转移瘤的治疗中 ,单纯立体定向放射外科与立体定向放射外科合并全脑照射的效?Objective To determine if the whole brain radiotherapy (WBRT) is necessary in patients with single brain metastases from non small cell lung cancer treated with stereotactic radiosurgery (SRS).Methods 41 non small cell lung cancer patients with newly single brain metastases were prospectively categorized into SRS alone group,or WBRT combining with SRS group.Generally,for the SRS+WBRT patients SRS was given 7-14 days after the completion of WBRT.The endpoints evaluated included local control,KPS,local freedom from progression (LFFP) of tumors treated with SRS and/or WBRT,freedom from new brain metastases(FFNBM),causes of death.Results Median survivals in the patient groups of SRS alone,SRS+WBRT,were 9 3 months and 10 6 months,respectively.The median LFFPs were 6 9 months and 8 6 months.The median FFNBMs were 6 7 months and 8 6 months,respectively.The local control rates were 87 0% and 88 9%. The improvement rates of KPS were 82 6% and 88 9%,respectively.In univariate analysis there was not significant correlation except for FFNBM between the SRS±WBRT groups.Fortunately,6 patients with new brain metastases post SRS alone received salvage WBRT or SRS and the results were encouraging including CR in 2 patients, PR in 3 cases,and SD in the other one.Conclusions The results by the modality of SRS alone was similar to the combining of SRS and WBRT in the management of patients with solitary brain metastases from non small cell lung cancer.

关 键 词：非小细胞肺癌 单发脑转移瘤 放射治疗 研究 

分 类 号：R734.2[医药卫生—肿瘤]