X线立体定向放射治疗颅脑肿瘤的疗效观察

目的 :分析用 X线立体定向放射治疗 (stereotactic radiotherapy,SRT,简称 X-刀 )颅脑肿瘤的近期疗效 ,对治疗后的患者进行跟踪随访 ,并进行阶段性工作总结回顾。方法 :10 0例脑肿瘤患者 ,原发肿瘤 4 2例 ,转移性肿瘤5 8例 ,以 CT、MR和 DSA图像资料为定位依据 ,用德国 Brain L AB公司 Brain Scan治疗计划系统设计三维治疗方案 ,西门子 Mevatron MD- 2型直线加速器旋转照射。结果 :10 0例患者近期均取得满意效果。以 Karnofsky评分标准评价 ,临床症状有明显改善 ,SRT治疗后 1周～ 3周临床症状改善率为 83 % ,肿瘤局部控制率为 97.4 4% ,肿瘤消失率3月、6月、12月分别为 2 7%、5 4 %、85 % ,总有效率为 98.73 %。SRT加全脑放疗 79例 ,SRT剂量为 16Gy～ 3 0 Gy,每周 2次 ,全脑放疗 3周～ 4周 / 3 0 Gy～ 4 0 Gy。 2 1例仅应用了 SRT治疗。 5 8例脑转移瘤患者中位生存时间为 11个月 ,1年生存率为 75 .86%。 1.5年生存率为 4 1.3 8%。结论 :SRT治疗颅内肿瘤 ,跟踪观察发现 ,只要严格掌握适应证 ,精确定位 ,精密计划 ,精确摆位 ,精心操作 ,SRT是一种安全、高效、无痛苦的治疗脑肿瘤的方法。它可起到改善临床症状 ,提高生活质量 ,延长生存时间的作用。

OBSERVATION ON THE NEAR TERM EFFECTS OF X-RAY "KNIFE" STEREOTACTIC RADIOTHERAPY (SRT) IN PATIENTS WITH INTRACRANIAL TUMOR

Objective:To analyse the near term therapecutic effects of SRT in the patients with intracranial tumor and to perform the stage work summarization.Methods:Of the 100 patients with different kinds of intracranial tumor,42 cases were primary tumor,58 cases were metastatic tumor.Localization was based on the imaging data from CT,MR and DSA,German Brain LAB therapy program system was used for the design of three dimensional optimal program and Siemens MD type z linear accelerator was used for rotary exposure.Patients with metastatic tumor and some with gliomas underwent radiotherapy at entire or local brain.Results:Following the radiotherapy the near term therapeutis effects in all the 100 patients were satisfactory.The clinical symptoms evaluated by Karnofsky method had a favorablie turn.after the SRT;a 1～3 week improvement rate was 83%.Local control rate was 97.44%;diappearance rate of tumor was 27%,54%,83% for 3,6,and 12 months respectively.Total effective rate was 98.73%.79 cases were treated by SRT plus whole brain radiotherapy,with a SRT dosage of 16 Gy～30 Gy twice a week,and a whole brain radiotherapy dosage of 30 Gy～40 Gy for 3～4 weeks.21 cases were alone trated with stereotactic radiotherapy.In the 58 patients with metastatic brain tumor,one year survival rate was 75.86%,median survival time was 11 months,one and a half year survival rate was 41.38%.Conclusion:Follow up survey showed that if there are strictly setecting the indications,precise localization,carefully drawing up a plan,and exact manipulation,the SRT will be a safe,high effective,painless remedy for treating the intracranial tumor,playing a role in improving clinical condition,living quality,and prolonging the life.