肺癌脑转移瘤不同放射治疗方法的疗效分析  

The Effect Analysis of Brain Metastases From Lung Cancer with Different Radiotherapy Methods

作　　者：张国荣[1] 郁志龙[1] 刘秀兰[1] 

机构地区：[1]内蒙古医科大学附属医院放疗科伽玛刀中心,内蒙古呼和浩特010059

出　　处：《内蒙古医学杂志》2014年第6期651-654,共4页Inner Mongolia Medical Journal

基　　金：内蒙古自治区自然基金项目(2010MS1147)

摘　　要：目的分析不同的放射治疗方法治疗肺癌脑转移瘤的疗效。方法回顾性分析2010年6月至2013年6月期间在本院采用全脑放疗及伽玛刀治疗的126例有病理学证实的肺癌脑转移瘤患者的临床资料,其中男性66例,女性60例。根据肿瘤的大小、个数、位置及肿瘤周边正常织的耐受情况,对于转移病灶数≤5个的小病灶（直径〈3.0 cm）直接选择伽玛刀一次性治疗;而对于较大肿瘤病灶（直径≥3 cm但≤4 cm）选择伽玛刀二次剂量分割治疗。对于转移病灶数〉5个的肿瘤病灶,选择全脑放疗与伽玛刀相结合的治疗方法治疗。结果随访126例患者,随访期6~45个月,肿瘤控制率95%,中位生存期16.8个月,1年生存率63%,2年生存率25%。KPS评分在1个月内达到90分以上者占93%。结论伽玛刀治疗肺癌脑转移瘤安全有效,根据肿瘤大小、个数及神经功能受损情况选择不同的放射治疗方法综合治疗,能及时改善临床症状,减少放射损伤,显著提高患者生存质量,延长生存期。其疗效与肿瘤大小、位置、个数、治疗剂量及不同的放疗方法的选择有关。Objective To assess the clinical efficacy of brain metastases from lung cancer with different radiotherapy methods. Methods Analyzed retrospectively 126 cases diagnosed by pathology with brain metastasis patients from lung cancer were treated with whole brain radiotherapy and gamma knife radiosurgery from June2010 to June 2013 in our hospital. In 66 males and 60 females. The diameter of Metastase（ ＆lt; 3. 0cm） was treated by gamma knife. The diameter of Metastase（ ≥3cm 但≤4cm） was treated by fractionated treatment on gamma knife and 2 fractions one day. Whole brain radiotherapy plus gamma knife treatment for multiple brain metastasis（ ＆gt; 5）. Results 126 cases were followed- up 6 ~ 45months,The overall local tumor control rate was95%,the median survival was 16. 8 months,1 year survival rate was 63%,2 year survival rate was 25%. Karnofsky Performance Scale（ KPS） score was raised significantly and the KPS score ＆gt; 90 was 93% in one month.Conclusion Gamma knife radiosurgery for brain metastasis from lung cancer is a safe and effective method,it can relieve the clinical neurological symptoms and improve life quality of patients with brain metastasis of lung cancer,reduce radiation damage,and prolong patients’ survival time. The clinical efficacy of brain metastasis from lung cancer is relevant with tumor size,localization,radiation dose,and selection of different radiotherapy methods.

关 键 词：肺癌脑转移瘤 伽玛刀 全脑放疗 

分 类 号：R734.2[医药卫生—肿瘤]