伽玛刀分期与分次治疗大于3 cm非小细胞肺癌脑转移瘤的疗效比较  

Comparison of gamma knife staging and fractional treatment for brain metastases of non-small cell lung cancer greater than 3 cm

作　　者：何春雷 宋传臣[2] 白永瑞[2] HE Chunlei;SONG Chuanchen;BAI Yongrui(Hangzhou Mingzhou Hospital,Zhejiang Hangzhou 310000,China;Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200017,China.)

机构地区：[1]杭州明州医院,浙江杭州310000 [2]上海交通大学医学院附属仁济医院,上海200127

出　　处：《现代肿瘤医学》2022年第9期1657-1660,共4页Journal of Modern Oncology

基　　金：国家“十三五”重点研发计划(编号:2017YFC0113703)。

摘　　要：目的:回顾性分析伽玛刀分期与分次治疗最大直径大于3 cm的非小细胞肺癌脑转移瘤的疗效与毒副反应,探寻大于3 cm脑转移瘤伽玛刀合适的治疗方案。方法:选取两家伽玛刀中心治疗的128例最大直径大于3 cm的非小细胞肺癌脑转移瘤患者,依据治疗方法分为伽玛刀分期治疗组和伽玛刀分次治疗组,每组64例。比较2组的局控率,生存期,脑转移相关死亡,放射性脑坏死。结果:伽玛刀分期治疗组、伽玛刀分次治疗组1年局部控制率分别为89.1%、68.8%;伽玛刀分期治疗组、伽玛刀分次治疗组中位生存期分别为18个月、13个月;伽玛刀分期治疗组、伽玛刀分次治疗组的脑转移相关死亡率分别为12.5%、35.9%;伽玛刀分期治疗组、伽玛刀分次治疗组放射性脑坏死分别发生3例和1例。结论:伽玛刀分期治疗大于3 cm脑转移瘤疗效更好、毒副反应相当,是合适的治疗选择。Objective:To retrospectively analyze the efficacy and side effects of gamma knife in staged and fractionated treatment of brain metastasis of non-small cell lung cancer(NSCLC)with a maximum diameter of over 3 cm,and explore the appropriate treatment scheme of gamma knife for brain metastasis of over 3 cm.Methods:128 non-small cell lung cancer(NSCLC)patients with brain metastasis of more than 3 cm inmaximumdiameter were selected from two gamma knife centers.According to the treatment methods,they were divided into staged gamma-knife group and fractionated gamma-knife group,with 64 patients in each group.The local control rate,overall survival time,brain metastasis-related death and radioactive brain necrosis in the two groups were compared.Results:The 1-year local control rate of staged gamma-knife group and fractionated gamma-knife group was 89.1%and 68.8%respectively.The median overall survival time of staged gamma-knife group and fractionated gamma-knife group was 18 months and 13 months.Staged gamma-knife group and fractionated gamma-knife group had brain metastasis-related mortality of 12.5%and 35.9%.There were 3 cases and 1 case of radioactive brain necrosis in staged gamma-knife group and fractionated gamma-knife group.Conclusion:Gamma knife staged treatment for brain metastases larger than 3 cm has better efficacy and similar side effects than fractionatedtreatment,so it is an appropriate treatment choice.

关 键 词：脑转移瘤 伽玛刀 NSCLC 

分 类 号：R730.44[医药卫生—肿瘤]