γ刀分次立体定向放射治疗对非小细胞肺癌脑转移瘤的临床疗效及剂量学探讨  

An investigation of clinical efficacy and dosimetry of γ-knife fractionated stereotactic radiotherapy for NSCLC brain metastatic encephaloma

作　　者：李亚杰 郭少贤 吕冠群 韩世强 宋桂芳 赵媛 LI Ya-jie;GUO Shao-xian;LV Guan-qun(Oncology Department,The 981^th Hospital of People’s Liberation Army Joint Service Support Force,Chengde 067000,China;不详)

机构地区：[1]解放军联勤保障部队第981医院肿瘤科,河北承德067000

出　　处：《中国医学装备》2020年第11期18-22,共5页China Medical Equipment

摘　　要：目的:探讨γ分次立体定向放射外科(SRS)治疗对非小细胞肺癌(NSCLC)脑转移瘤的临床疗效及剂量学。方法:选取在医院住院治疗的64例非小细胞肺癌脑转移瘤患者,进行γ刀分次SRS。观察分析患者的病情改善程度以及影响患者生存因素。结果:治疗后64例NSCLC脑转移患者的病情呈现出不同程度的改善,其中转移病灶直径≤3 cm(47例)和>3 cm(17例)的治疗有效率分别为87.23%和58.82%,差异有统计学意义(x^2=5.269,P<0.05),脑转移灶≤3个(51例)和>3个(13例)的治疗有效率分别为86.27%和53.85%,差异有统计学意义(x^2=5.526,P<0.05);患者年龄、性别病变数量、放射治疗剂量大小以及是否全脑放射治疗(WBRT)是影响患者生存时间的单因素,差异无统计学意义,影响患者生存的因素有卡氏功能量表(KPS)评分、原发病灶是否被控制、是否存在其他转移、放射治疗得分指数(SIR)以及递归分隔分析(RPA)分级(r=0.124,r=0.136,r=-0.289,r=-0.262,r=-0.217;P<0.05);未出现Ⅲ级神经系统的不良反应,未出现脑梗死以及颅内出血等严重的并发症。典型病例经过SRS+WBRT治疗后,经X射线计算机断层扫描(CT)及磁共振成像(MRI)检查结果提示,患者的头部肿瘤病灶达到完全缓解,且肺部的肿瘤病灶稳定。结论:使用γ刀分次SRS对NSCLC脑转移瘤进行治疗,可提高治疗有效率,延长患者的生存时间,减轻不良反应的症状。Objective:To investigate clinical efficacy and dosimetry ofγ-knife fractionated stereotactic radiotherapy for non-small cell lung cancer(NSCLC)brain metastatic encephaloma.Methods:A total of 64 patients with NSCLC brain metastatic encephaloma in our hospital were selected,and they underwentγ-knife stereotaxic radio surgery(SRS).The improvement degree of the condition of patients and the factors that affected the survival of patients were observed and analyzed.Results:After treatment,the conditions of 64 patients with NSCLC brain metastases appeared improvement at different degrees,and the effective rates of treatment were 87.23%and 58.82%when the diameter of metastatic lesion of 47 cases was less and equal to 3cm and that of 17 cases was larger than 3cm,respectively,and the difference of that between them was significant(x^2=5.269,P<0.05).And the effective rates of treatment were 86.27%and 53.85%when the number of brain metastases of 51 cases was less and equal to 3 and that of 13 cases was larger than 3,respectively,and the difference of that between them was significant(x^2=5.526,P<0.05).Patient age,gender,number of lesions,the radiotherapy dose,and whether the whole brain received radiation therapy were single factors that could affect survival time of patients,and the differences of them were no significant.And the factors that affected the survival of patients included the score of Karnofsky performance scale(KPS),whether the primary lesion was controlled,whether there were other metastases,score index for radiotherapy(SIR)and the grading of recursive partitioning analysis(RPA)(r=0.124,r=0.136,r=-0.289,r=-0.262,r=-0.217,P<0.05).And there was no adverse reaction in nervous system of grade III,and there were no serious complications such as cerebral infarction and intracranial hemorrhage.The results of computed tomography(CT)and magnetic resonance imaging(MRI)indicated that the brain tumor lesions of patients were complete remission,and the lung tumor lesions of them were stability after they underwent SRS a

关 键 词：非小细胞肺癌(NSCLC) γ刀分次立体定向放射治疗 脑转移瘤 剂量学 

分 类 号：R816.1[医药卫生—放射医学]