颅内转移瘤的综合治疗(附80例临床分析)

Combined Therapy of Intracranial Metastases (Clinical Analysis of 80 Cases)

背景与目的:脑转移瘤是成人最常见的颅内肿瘤,脑转移瘤的治疗仍存在争议。本文探讨颅内转移瘤诊断和最佳的综合治疗方法。方法:本文回顾性分析我院近8年经以手术、放疗和化疗为主综合治疗的80例颅内转移瘤患者的预后。术前明确有肿瘤或肿瘤手术史76例,另4例术前肿瘤性质不明。结果:手术行转移灶完全切除者50例,其中原发病灶完全切除者28例,原发灶放疗或化疗者22例;多发灶只清除1个者11例;其余19例只行放疗加化疗。原发病灶中肺癌40例,占已知病灶52.6%,病理类型以腺癌和低(未)分化癌为多见,分别为41.2%和36.4%。本组生存时间最短3个月,最长3年零7个月,中位生存期17个月,平均生存期16个月,只行放疗加化疗者平均生存期11个月。与同期未经综合治疗者相比,本组患者生存期明显延长。结论:脑转移瘤诊断一经确立,治疗上应采取积极态度、手术切除肿瘤、去骨瓣减压、明确病理类型至关重要,再针对病理类型行放疗和/或化疗等其他综合治疗措施,对延长患者生存时间有帮助。

BACKGROUND ＆ OBJECTIVE： Brain metastases are the most common intracranial tumors in adult. The treatment of brain metastases remains controversial. In the present article, we investigate the optimal combined therapy of intracranial metastases. METHODS： Eighty cases with intracranial metastases that were treated with combined therapy including operation, radiotherapy and chemotherapy were analyzed retrospectively. Seventy-six cases had definite tumor history, while remained 4 cases were uncertain preoperatively. RESUITS： Intracranial metastasis and the primary lesions were totally resected in 28 cases. Intracranial metastasis was total resected and primary lesion treated with radiotherapy or chemotherapy was in 22 cases. 0nly one lesion of muhiple metastases was removed in 11 cases. The remained 19 cases were treated with radiotherapy and chemotherapy. In this group, the shortest survival time was 3 months while the longest was 3 years and 7months. The nredian survival time was 17 months, and the average survival time was 16 months. The average survival time in patients treated with radiotherapy and chemotherapy wag 11 months. Compared with those patients without combined therapy,the patients in this group had the longer average survival time. CONCLUSION： Once the diagnosis of intracranial metastasis is established, the effective treatment such as surgical and medical treatment of raised intraeranial pressure, radiotherapy and chemotherapy should be offered to the patients.