单纯立体定向放射外科治疗脑转移瘤84例临床分析

Clinical analysis of predictors in survival for patients with brain metastases treatedwith stereotactic radiosurgery alone

目的评价单纯立体定向放射外科(SRS)治疗脑转移瘤的效果以及预后因素。方法回顾性分析经单纯SRS治疗的脑转移患者84例,计算患者的生存期及局控率,对潜在预后因素进行分析。结果全部84例患者的中位生存期为9个月。多因素分析仅KPS>70和转移灶体积≤4cm3为生存独立预后因素。77例有影像学随访资料的患者中,100个转移灶的总体局控率和1年局控率分别为91.7%和85.3%,单因素分析中仅原发灶部位是影响局控率的预后因素。结论SRS是脑转移的有效治疗方式,多种因素影响其预后。

Objective To determine the outcome for brain metastases patients treated with linac-based stereotactic radiosurgery （SRS） alone and evaluate the potential prognostic factors. Methods We reviewed 84 patients who were managed with a linac-based SRS alone from 1994 to 2002. Seventy-seven patients with 100 lesions were evaluable for local tumour control analysis with follow-up imaging. Survival and local control were estimated using Kaplan-Meier method. The potential prognostic factors were analysed at the same time with univariate and multivariate analysis. Results The median survival for all 84 patients was nine months. In multivariate analysis, KPS score〉70 （P=0. 0017） and tumor volume≤4 cm^3 were independent significant factors for survival. The overall local tumor control rate and the actuarial local tumor control rate at 1 year were 91.7% and 85. 3%, respectively. Primary tumor location （P=0. 034） was the single significant predictor for local tumor control in univariate analysis. Conclusion SRS is an effective method for treatment of brain metastases. Several predictors are detected for local tumor control and survival.