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1.
星形胶质细胞瘤伽玛刀治疗的疗效与影响因素 总被引:6,自引:0,他引:6
目的分析星形胶质细胞瘤伽玛刀(γ-刀)治疗的疗效与影响因素.方法回顾性分析48例星形胶质细胞瘤病人的γ-刀治疗结果.以性别、有无普通放疗经过、有无化疗经过、边缘剂量、病灶的平均直径、病变的病理等级、影像学上有无相对较清楚的边界为治疗结果影响因素,判定标准以病灶缩小为有效,采用logistic回归模型,确定多因素条件下治疗结果的影响因素.结果有效32例(66.7%),logistic回归模型分析表明:病理等级和病灶平均直径为与肿瘤控制有关的影响因素.结论γ-刀对星形胶质细胞瘤的治疗有一定的意义. 相似文献
2.
本文介绍了在立体定向放射神经外科中,根据病人配戴头环和CT定标架作CT扫描所得的CT断层图像或配戴AVM定位箱做血管造影得到的两张X光片确定病人颅内病灶的三维坐标的方法。 相似文献
3.
立体定向放射性脑水肿危险性因素分析 总被引:1,自引:0,他引:1
目的 分析立体定向放射外科(SRS)诱导放射性脑水肿的危险因素。方法 回顾性分析接受X刀治疗且有完整影像学随访资料的病人67例,分成两组:水肿组(22例)、对照组(47例),采用单因素分析(χ^2或Wilcoxon秩和检验)和logistic回归分析方法分析年龄、性别、肿瘤体积、最大剂量、边缘剂量、肿瘤位置、靶点数目、10Gy剂量覆盖的体积及随访时间对治疗后脑水肿的影响。结果 单因素分析提示肿瘤体 相似文献
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R. Deruty I. Pelissou-Guyotat C. Mottolese D. Amat Y. Bascoulergue 《Acta neurochirurgica》1994,131(3-4):169-175
Summary The prognostic value of the Spetzler's grading system is studied in a series of 52 AVMs treated by a combined management, using one or several of the 3 available techniques: surgical resection, endovascular embolization, radiosurgery.The symptoms at the time of treatment were haemorrhage 50%, seizures 31%, headache and deficit 19%. Three grade groups were considered: I and II (31%), III (33%), IV and V (36%). Overall, AVMs were managed as follows: resection alone 25%, embolization plus resection 23%, embolization alone 23%, radiosurgery with various combinations 29%. According to the grade groups, the most frequently used technique was resection alone for grade I–II AVMs (44%), radiosurgery for grade III AVMs (41%) and embolization alone for grade IV–V AVMs (42%).The clinical outcome was evaluated in terms of deterioration due to treatment. The best results were obtained in grade I–II AVMs (81% with no deterioration) then in grade III AVMs (65%) and in grade IV–V (58%). However, when we consider the outcome in terms of favourable results (no or only minor deterioration) we obtained a similar outcome for grade I–II and grade III AVMs (94% each), and only 79% for grade IV–V malformations. The angiographic outcome showed a better eradication rate in grade III AVMs (88% complete eradication), than in grade I–II AVMs (75%) and in grade IV–V (47%).Our conclusion is that the Spetzler's grading system in this series was well correlated with both the clinical and the angiographic outcome. However, we found no real difference between grade I–II and grade III AVMs. So, in terms of prognostic value, the grade I, II, and III AVMs could be considered together as low-grade malformations, with a better prognosis than the high-grade malformations (grade IV and V). 相似文献
6.
JI Tang M Back T Shakespeare JJ Lu R Mukherjee C Wynne S Liang 《Journal of Medical Imaging and Radiation Oncology》2005,49(5):390-395
The aims were to determine the median survival and prognostic factors of patients with central nervous system (CNS) metastases managed with whole‐brain radiation therapy (WBRT), and to explore selection criteria in recently published clinical trials using aggressive interventions in CNS metastases. A retrospective audit was performed on patients managed with WBRT for CNS metastases. Potential prognostic factors were recorded and analysed for their association with survival duration. The proportion of patients with these factors was also compared with those of patients managed under three recently reported studies investigating aggressive interventions, such as radiosurgery and chemotherapy for CNS metastases. Seventy‐three patients were treated with WBRT for cerebral metastases over a 12‐month period. The median survival of the population was 3.4 months (95% confidence interval: 2.7–4.1), with 6‐ and 12‐month survival rates of 30 and 18%, respectively. Significant prognostic factors for prolonged median survival were Eastern Cooperative Oncology Group status 0–2 (P = 0.015), Medical Research Council neurological functional status 0–1 (P = 0.006), and Recursive Partitioning Analysis Class 2 versus Class 3 (P = 0.020). On multivariate analysis, younger patient age (P = 0.02) and better performance status (P < 0.01) were associated with improved outcome. When comparing these characteristics with selected published studies, our study cohort demonstrated a higher proportion of patients with poor performance status, a greater number of metastases per patient and a higher incidence of extracranial disease. This reflects the selected nature of patients in these published studies. Central nervous system metastases confer a poor prognosis and, for the majority of patients, aggressive interventions are unlikely to improve survival. The use of potentially toxic and expensive treatments should be reserved for those few in whom these studies have shown a potential benefit. 相似文献
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A Comprehensive Evaluation of Single Isocenter Multiple Target SRS Plans and the Analytical Relationship between Plan Quality Indices with the Number and Volume of Targets 下载免费PDF全文
9.
目的探讨不同的血管性疾病γ刀治疗后脑水肿的发生率。方法回顾十余年内经γ刀治疗的血管性病变358例,采用χ^2检验探讨γ刀术后不同血管性病变及不同随访时间脑水肿发生率的差异性。结果γ刀术后,动静脉畸形(AVM)组水肿阳性率为47.5%,海绵状血管瘤组为25.9%,术后水肿发生率有显著性差异(P〈0.01)。不同随访阶段水肿阳性率分别为:≤1年为47.3%,1~3年为38.0%,3~5年为37.1%,〉5年为25.0%,不同随访阶段脑水肿发生率有显著性差异(P〈0.01)。结论脑水肿是γ刀治疗后最重要的并发症之一,术后1年内水肿的发生率最高。 相似文献
10.
目的 分析接受立体定向放射外科(SRS)治疗的脑转移瘤(BM)患者颅内出血(ICH)发生和致死的风险因素。方法 筛选符合纳排标准的BM患者392例,分析其临床资料,包括患者项目、SRS项目、血液学项目和影像学项目。首先,根据患者接受SRS后是否出血分为ICH组(n=134)和非ICH组(n=258)。对两组行Logistic回归分析ICH发生的风险因素。之后,再分析ICH组致死的风险因素。结果 有ICH史、原发灶为恶性黑色素瘤是接受SRS后BM患者ICH发生的风险因素,有ICH史和原发灶为恶性黑色素瘤的患者ICH发生风险分别提高了7.433和1.430倍(均P<0.05)。ICH组7 d内和30 d内死亡率分别为11.19%和25.37%。高血压、血小板计数、脑疝和脑积水是7 d内死亡的危险因素(均P<0.05)。脑疝和脑积水是30 d内死亡的危险因素(均P<0.05)。结论 对于具备相应风险因素的患者,需提前做好预防和治疗准备,从而降低ICH发生和致死率。 [国际神经病学神经外科学杂志, 2023, 50(6): 34-39] 相似文献