伽玛刀治疗脑转移瘤的疗效观察

目的探讨伽玛刀治疗脑转移瘤的临床效果,以提高患者的生存质量并延长其生存期。方法 2003年3月—2009年3月,采用伽玛刀治疗脑转移瘤800例;平均每次治疗（3.6±2.5）个病灶,肿瘤平均直径（3.0±0.4）cm。对病灶较多、体积较大的转移瘤病灶行分次治疗。结果治疗后6～12个月随访到610例患者,平均生存期为（11.2±1.94）个月,中位生存期为8.3个月;治疗后6个月、1年的生存率分别为88.7%和52.3%;肿瘤控制率为93%;KPS评分明显提高;并发症发生率多发病灶较单发病灶高,体积大者较体积小者高（P〈0.01）。结论伽玛刀治疗多发性脑转移瘤具有侵袭小、痛苦少、治疗时间短、效果好、安全可靠、并发症低的特点,可作为脑转移瘤、尤其是多发性脑转移瘤的首选治疗手段。

Observation on efficacy of gamma knife in treatment of metastatic encephaloma

Objective To evaluate the efficacy of gamma knife in treatment of metastatic encephaloma,improve the quality of life and extend the lifetime of patients. Methods 800 patients with metastatic encephaloma were treated by gamma knife between March 2003 and March 2009.Average（3.6±2.5） lesions were treated at a time;the average diameter of tumors was（3.0±0.4） cm.fractionated gamma knife surgery should be used for large tumor with multiple lesions. Results A total of 610 patients were followed up for 6-12 months,the mean survival time was（11.2±1.94） months,and the median survival time was 8.3 months.6 months survival rate and one year survival rate were 88.7% and 52.3% respectively.The tumor control rate was 93 %.GKS can make the KPS score obvious improved.The complication rate of multiple tumor is more than the single,larger tumor is more than the smaller（P0.01）. Conclusion Gamma knife can be used as the preferred treatment method in cases with brain metastases which has the characteristic of small invasion,less pain,short treatment time,safe,effective and less complication.