| 伽玛刀立体定向放疗结合全脑照射治疗脑转移瘤临床效果分析 |
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| 引用本文： | 彭功勋,戴卓捷,任晔,马慧珍,崔迪,苏晓明,樊晶晶,申玉龙,王宗烨.伽玛刀立体定向放疗结合全脑照射治疗脑转移瘤临床效果分析[J].中华放射医学与防护杂志,2011,31(6):688-692. |
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| 作者姓名： | 彭功勋 戴卓捷 任晔 马慧珍 崔迪 苏晓明 樊晶晶 申玉龙 王宗烨 |
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| 作者单位： | 安徽医科大学附属解放军第306临床医院放疗科, 北京,100101 |
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| 摘 要： | 目的 分析立体定向放疗结合全脑照射治疗脑转移瘤的疗效和预后,同时观察服用替莫唑胺(TMZ)与放疗结合对患者生存率的影响。方法 脑转移瘤患者52例,按照治疗方法不同分为2组,一组为全脑照射(WBRT)+立体定向放疗(SRT,伽玛刀),共35例,一组为单纯SRT,共17例。全脑放疗分次剂量为1.8~3.0 Gy/次,1 次/d,5 次/周,总剂量DT30~40 Gy,WBRT+SRT组全脑后伽玛刀补量采用45%~75%等剂量曲线包绕PTV,边缘剂量12~15 Gy,中心剂量20~30 Gy。单纯SRT组分次立体定向放疗采用45%~75%等剂量曲线包绕PTV,边缘剂量36~40 Gy,中心剂量70~80 Gy。随访1~2年。所选52例患者中有20例患者放疗期间及放疗后服用替莫唑胺胶囊,同步化疗组化疗方案为:口服替莫唑胺75 mg/m2,1次/d,直至放疗结束,放疗结束后再服用3~6个月,剂量改为150 mg/m2。结果 放射治疗后1~3个月,复查CT/MRI显示总有效率(CR+PR)为84.62%,WBRT+SRT组有效率为88.57%,SRT组有效率为76.47%;肿瘤的6个月及1年的局部控制率分别为92.10%和85.20%。WBRT+SRT组的平均生存期13.2个月,中位生存期11个月;6个月生存率为71.40%,12个月生存率为54.30%,18个月生存率为14.30%。SRT组的平均生存期10.2个月,中位生存期9个月;6个月生存率为41.20%,12个月生存率为23.50%,18个月生存率为5.88%。替莫唑胺+放疗与单纯放疗的6个月、12个月及18个月生存率分别为80.00%和56.30%、60.00%和37.50%、10.00%和12.50%。结论 WBRT+SRT治疗脑转移瘤总体上优于单纯SRT治疗。放疗+TMZ联合治疗与单纯放疗相比,替莫唑胺在放疗过程中服用可提高患者生存率,不良反应无显著增加。
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| 关 键 词： | 伽玛刀 立体定向放疗 脑转移瘤 替莫唑胺 |
| 收稿时间： | 2011/5/10 0:00:00 |
Efficacy of gamma knife stereotactic radiotherapy and whole-brain radiotherapy in treatment of brain metastases |
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| PENG Gong-xun,DAI Zhuo-jie,REN Ye,MA Hui-zhen,CUI Di,SU Xiao-ming,FAN Jing-jing,SHEN Yu-long and WANG Zong-ye.Efficacy of gamma knife stereotactic radiotherapy and whole-brain radiotherapy in treatment of brain metastases[J].Chinese Journal of Radiological Medicine and Protection,2011,31(6):688-692. |
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| Authors: | PENG Gong-xun DAI Zhuo-jie REN Ye MA Hui-zhen CUI Di SU Xiao-ming FAN Jing-jing SHEN Yu-long and WANG Zong-ye |
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| Institution: | Department of Radiation Oncology, PLA 306 Hospital of Anhui Medical University, Beijing 100101,China;Department of Radiation Oncology, PLA 306 Hospital of Anhui Medical University, Beijing 100101,China;Department of Radiation Oncology, PLA 306 Hospital of Anhui Medical University, Beijing 100101,China;Department of Radiation Oncology, PLA 306 Hospital of Anhui Medical University, Beijing 100101,China;Department of Radiation Oncology, PLA 306 Hospital of Anhui Medical University, Beijing 100101,China;Department of Radiation Oncology, PLA 306 Hospital of Anhui Medical University, Beijing 100101,China;Department of Radiation Oncology, PLA 306 Hospital of Anhui Medical University, Beijing 100101,China;Department of Radiation Oncology, PLA 306 Hospital of Anhui Medical University, Beijing 100101,China;Department of Radiation Oncology, PLA 306 Hospital of Anhui Medical University, Beijing 100101,China |
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| Abstract: | |
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| Keywords: | Gamma knife Stereotactic radiotherapy Brain metastases Temozolomide |
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