伽玛刀立体定向放射外科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近期临床疗效及不良反应。方法选择脑转移瘤患者48例（108个病灶）采用伽玛刀治疗,肿瘤周边剂量14-21Gy,平均18Gy;中心最大剂量32-40Gy,平均35.4Gy。结果对48例患者伽玛刀治疗后进行临床随访,随访时间为1-27个月,平均10个月,完全缓解8例（16.7%）,部分缓解26例（54.2%）,无变化10例（20.8%）,进展4例（8.3%）,肿瘤局部控制率为91.7%（44/48）。有神经系统症状33例患者,神经症状完全缓解11例（33.3%）,部分缓解21例（63.6%）,所有患者KPS评分均有上升。平均生存期17.4个月,未出现严重不良反应。结论伽玛刀治疗脑转移瘤具有疗效好、安全的优势,能有效提高脑转移瘤患者生活质量,延长生存期。

Observation of gamma knife stereotactic radiosurgery for brain metastases

Objective To investigate the gamma knife radiosurgery for brain metastases of recent clinical efficacy and adverse reactions.Methods 48 cases of patients with brain metastatic tumor（108lesions）by gamma knife treatment,the tumor margin dose of 14-21Gy,average 18Gy;maximum dose of 32-40Gy,average 35.4Gy.Results The clinical follow-up of patients after gamma knife treatment in 48 cases,followed up for 1-27months,average 10 months,8cases of complete remission（16.7%）,partial remission in 26cases（54.2%）,no change in 10cases（20.8%）,4cases of progress（8.3%）,local tumor control rate was 91.7%（44/48）.Nervous system symptoms in 33 patients,neurological symptoms were completely relieved in 11（33.3%）,partial remission in 21cases（63.6%）,all patients with KPS score increased.The average survival time was 17.4months,no serious adverse reactions.Conclusion Gamma knife radiosurgery for brain metastases has good curative effect,safety advantage,can effectively improve the quality of life of patients with brain metastatic tumor,prolong the survival period.