130例脑转移瘤常规放疗和调强放疗的疗效分析

目的 评价调强放射治疗在脑转移瘤治疗中的疗效.方法 将130例脑转移瘤患者随机分成常规放疗组和调强放射治疗组.常规放疗组64例,先行全脑放射治疗(WBRT)36～40 Gy后,局部缩野加量,总剂量到50～60 Gy,每次2 Gy,5次/周.调强放射治疗组66例,全脑放射治疗剂量39.2～39.6Gy,脑转移灶剂量54～60 Gy,5次周,共23次.结果 治疗结束后3月、6月复查,对1～3个脑转移灶患者,常规放疗组和调强放疗组的中位生存期、有效率(CR+ PR)和1年生存率分别为13月、82％、59％和14月、88％、61％.对于脑转移灶数目大于3个的患者,常规放疗组和调强放疗组的中位生存期、有效率(CR+ PR)和1年生存率分别为9月、73％、47％和13月、87.5％、59％.结论 调强放射治疗可能是多发脑转移瘤患者的一种较常规全脑放疗更有效的治疗手段.

Comparative Analysis of Curative Effect between Conventional Radiotherapy and Intensity-modulated Radiotherapy for 130 Patients with Brain Metastasis

Objective
To evaluate the effects of the intensity-modulated radiation therapy(IMRT) in the treatment of brain
metastasis.MethodsOne hundred and thirty cases of patients with brain metastasis were randomly divided into two
groups.Conventional radiotherapy groups:64 cases,the whole brain radiotherapy (WBRT) 36-40 Gy in
advance,concomitantly boost to 50-60 Gy,2 Gy/time,five times per week.While intensity-modulated radiation treatment
group:66 cases,the whole brain radiotherapy dose 39.2-39.6 Gy,brain metastasis dose 54-60 Gy,5 times/week for 23
times.ResultsAfter the treatment 3 months and 6 months,the 1-3 of brain metastasis patients,conventional radiation
therapy group and the IMRT group of median overall survival time,efficient (CR+PR) and 1 year survival rates were 13
months,82%,59% and 88%,61%,14 months respectively.The number of brain metastasis more than three
patients,conventional radiation therapy group and the IMRT group of median overall survival time,efficient (CR+PR)
rate and 1 year survival rates were 9 months,73%,47% and 13 months,87.5%,59% respectively.ConclusionIMRT can be a
more effective treatment method for the patients with multiple brain metastasis than conventional radiotherapy.