肾上腺转移瘤的伽马刀治疗

目的探讨肾上腺转移瘤的伽马刀治疗效果。方法对20例肾上腺转移瘤病人,用伽马刀进行肾上腺转移瘤适形放射外科治疗,以50%~60%等剂量曲线包绕病灶,周边剂量3.5Gy~4.5Gy,隔日1次,共8~10次。结果除2例因全身多处转移伴全身衰竭未完成治疗外,18例患者完成治疗。5例患者治疗后有2例生存超过1年,1年生存率为40%(2/5)。治疗后超过6个月的12例患者中,10例生存;6个月生存率为83.3%(10/12)。随访患者平均生存时间10个月。伽马刀治疗后3个月后复查,根据B超和CT检查肾上腺转移瘤,88.9%(16/18)患者的转移瘤有不同程度的缩小。77.8%(14/18)患者原有的腰痛症状逐步减轻。结论肾上腺转移瘤对放射治疗敏感,伽马刀治疗肾上腺转移瘤是比较安全有效的姑息治疗,无严重并发症。

Gamma Knife Radiosurgery for Adrenal Gland Metastases

Objective To investigate gamma knife radiosurgery for adrenal gland metastases.Methods We retrospectively studied 20 patients with adrenal gland metastases treated with gamma knife radiosurgery.Each tumor was given an isobaric curve coverage of 50%-60% and a peripheral dose of 3.5-4.5 Gy each time,respectively.Each patient was given 350-450 Gy in total.Results The pain of waist in 10 patients (14/18 77.8%) basically disappeared after 3-5 times' treatment.Eighteen patients were followed up for 3-12 months (median=10 months) and two patients died in three months due to multiple organ failure.And 83.3% of the patients (10/12) had a significant improvement in the survival of six months and 40% of the patients (2/5) had a survival longer than one year.Medium overall survival time after gamma knife therapy was 10 months and the overall response rate was 88.9% in the 18 patients.Conclusion Adrenal gland metastases are sensitive to radiation treatment.Gamma knife rediosurgery is a safe and effective method to adrenal gland metastases and a good palliation therapy.