脑转移瘤放疗模式的探讨  

Discussion on Radiotherapy of Brain Metastases

作　　者：彭苗[1] 苏琼菲[1] 莫凯岚[1] 丁颖[1] 刘晓清[1] 杨帆[1] 王希成[1] 

机构地区：[1]广东药学院附属第一医院肿瘤科,广东广州510080

出　　处：《临床医学工程》2016年第6期789-791,共3页Clinical Medicine & Engineering

摘　　要：目的探讨脑转移瘤的放疗模式。方法将194例脑转移瘤患者分为三组:A组行全脑放疗(WBRT),B组行立体定向放射治疗(SRS),C组行WBRT联合SRS,对比三组的复发率、无复发生存率,对总生存进行单因素、多因素生存分析。结果整组颅内转移瘤远处复发率为19.6%,A、B、C三组复发率分别为15.8%、34.5%、11.1%,三组比较有统计学差异(P=0.003)。整组总体1年无复发生存率40.1%,A、B、C三组1年无复发生存率分别为53.4%、23.6%、37.4%,三组比较有统计学差异(P=0.016)。单因素及多因素预后分析提示RPA分级为独立预后因素。结论脑转移瘤患者单独使用SRS复发率高,SRS联合WBRT治疗较WBRT、SRS并未延长总生存。Objective To discuss the radiotherapy mode of brain metastases. Methods 194 patients with brain metastases were divided into three groups： group A was given whole brain radiotherapy （WBRT）, group B was given stereotactic radiosurgery （SRS）, group C was given WBRT combined with SRS. The recurrence rate, recurrence-free survival rate of three groups were compared, the overall survival was analyzed univariate and multivariate regression. Results The distant recurrence rate of intracranial metastasis of total group was 19.6%, the recurrence rates of group A, group B and group C were 15.8%, 34.5%, 11.1% respectively, the difference between three groups was statistical （P= 0.003）. The 1-year recurrence-free survival rate of total group was 40.1%, and the group A, group B and group C were 53.4%, 23.6%, 37.4% respectively, the difference between three groups was statistical （P= 0.016）. The univariate and multivariate survival analysis showed that RPA grading was independent prognostic factor. Conclusions Brain metastases patients treated with simple SRS have high recurrence rate. SRS combined with WBRT do not prolong overall survival compared with WBRT or SRS.

关 键 词：脑转移瘤 全脑放疗 立体定向放疗 预后 

分 类 号：R739.4[医药卫生—肿瘤]