颅脑X刀治疗脑转移瘤临床疗效分析  

Clinical effect analysis of X-knife radiotherapy for brain metastases

作　　者：谌龙 孙娟 时晓玲 孙朝军 

机构地区：[1]河南省舞阳县人民医院肿瘤科,462400

出　　处：《中国实用医刊》2016年第19期69-71,共3页Chinese Journal of Practical Medicine

摘　　要：目的 探讨颅脑X刀治疗脑转移瘤的疗效.方法 选择2006年1月至2014年1月40例有原发灶或转移灶病理报告的脑转移患者进行颅脑X刀治疗,边缘剂量8 Gy/次,共4次,隔日1次.并在颅脑X刀治疗后进行了全脑放疗,2 Gy/次,共15次.对其近期和远期疗效进行分析.结果 全组患者随访期18-52个月,中位随访时间30个月,随访率为95％.不同肿瘤患者发生脑转移治疗后的中位生存时间：肺癌10个月,结肠癌10个月,乳腺癌15个月,其他9个月.单发转移18例患者与多发转移22例患者生存率及颅内转移灶无进展生存率比较差异也未见统计学意义;转移灶体积≤12 cm^3、〉 12 cm^3两组坏死发生率和病灶局部控制率分别为15％、50％和85％、50％,差异均有统计学意义;放疗前有肿瘤坏死的病灶局部控制率为67％,低于无坏死病灶局部控制率（88％）;不同病理类型脑转移病灶的局部控制率比较差异未见统计学意义.结论 颅脑X刀治疗能延长所有病理类型脑转移瘤患者的中位生存期.体积≤12 cm^3的脑转移病灶的局部控制率较高.Objective To investgate the effect of X-knife radiotherapy on brain metastases.Methods Forty patients with brain metastases from January 2006 to January 2014 were selected and treated by 6-xay linear accelerator based X-knife radiotherapy.All patients had pathological diagnosis of the primary focus or the metastatic focus,with marginal dose of 8 Gy/F,4 times in total,each time every other day.Whole brain radiotherapy was conducted after X-knife radiotherapy in the brain,2 Gy/F,15 times in total.Short-term and long-term efficacy were analyed.Results All of the cases were followed up for 18 to 52 months,with median follow up time of 30 months,the follow-up rate was 95%.The median survival time of brain metastases from different tumor after treatment were：lung cancer 10 months,colon cancer 10 months,breast cancer 15 months,others 9 months.The transfer of 18 cases of single and multiple metastases in 22 patients survival rate and progression-free survival had no significant difference;the incidence of necrosis and lesion local control rates the groups of metastasis volume below 12 cm^3,and that of above 12 cm^3 were 15%,50% and 85%,50% respectively,and the differences were significant.The lesion local control rate before radiotherapy of tumor necrosis was 67%,which was lower than 88% of the non-necrotic lesion local control rate.The local control rate of different pathological types of brain metastasis had no difference.Conclusions Stereotactic radiotherapy may prolong the medium survival time in patients who suffer from brain metastasis with any kind of pathological diagnosis.Local focus control of the brain metastatic tumor below 12 cm^3 is higher.

关 键 词：脑转移瘤 放射治疗 放射外科手术 治疗结果 

分 类 号：R739.41[医药卫生—肿瘤]