可切除脑转移瘤术前立体定向放射外科的研究进展  

Research progress in preoperative stereotactic radiosurgery for resectable brain metastases

作　　者：张雪芳 何洁芳 陈媛媛[3] Zhang Xuefang;He Jiefang;Chen Yuanyuan(Guangdong Medical University,Zhanjiang 524000,China;Department of Radiation Oncology,The 10th Affiliated Hospital of Southern Medical University,Dongguan 523059,China;Department of Radiation Oncology,State Key Laboratory of Oncology In South China,Guangdong Provincical Research Center for Cancer,Sun Yat-Sen University Cancer Center,Guangzhou 510060,China)

机构地区：[1]广东医科大学,湛江524000 [2]南方医科大学第十附属医院肿瘤放疗科,东莞523059 [3]华南恶性肿瘤防治全国重点实验室,广东省恶性肿瘤临床医学研究中心,中山大学肿瘤防治中心肿瘤放疗科,广州510060

出　　处：《中华放射肿瘤学杂志》2023年第12期1093-1098,共6页Chinese Journal of Radiation Oncology

基　　金：东莞市科技特派员项目(20211800500322);东莞市社会发展科技项目(20231800935742);国家自然科学基金(82272744);广东省自然科学基金(2022A1515010814)。

摘　　要：手术联合术后立体定向放射外科(SRS)治疗提高了可切除脑转移瘤患者的总生存,成为可切除脑转移瘤重要的治疗模式之一。与之相比,术前SRS具有减少术中有活性的肿瘤细胞播散到治疗腔、降低照射剂量、减少对周围正常脑组织的照射、保证了围术期治疗的顺利进行等理论优势,而且被近年的临床研究证实其可降低局部复发率、放射性脑坏死和软脑膜转移的发生率。另外,其适应证、剂量分割及联合药物治疗等实施细节有待更多前瞻性研究证实。本文对该治疗策略的研究进展进行综述。Surgery combined with postoperative stereotactic radiosurgery(SRS)can improve the overall survival and becomes one of main treatments for resectable brain metastases.Compared with postoperative SRS,preoperative SRS(Pre-SRS)has theoretical advantages of reducing the dissemination of active tumor cells into the treatment cavity during surgery,reducing radiation dose,reducing radiation to surrounding normal brain tissue,and ensuring successful implementation of perioperative treatment,etc.Recent clinical studies have confirmed that Pre-SRS can reduce local recurrence rate and the incidence of radiation necrosis(RN)and leptomeningeal metastasis(LMM).Moreover,the indications,dose fractionation,and combined therapy remain to be confirmed by more prospective studies.In this article,research progress in Pre-SRs for resectable brain metastases was reviewed.

关 键 词：肿瘤转移 脑 肿瘤/外科手术 立体定向放射外科 术前治疗 

分 类 号：R739.41[医药卫生—肿瘤]