肺癌脑转移及其外科治疗

Cerebral metsstases from lung cancer and their surgical manegement

分析报告肺癌脑转移１０８例的临床表现、病理、诊断和治疗，特别对诊断和外科治疗进行了讨论。单个脑转移瘤，只要位于可切除部位，病人一般情况尚好，应首选手术切除加术后全脑放射治疗。对术后复发的单个脑转移瘤仍可再切除。下列情况的多发脑转移瘤亦有手术切除指征：（１）两个彼此相邻的转移瘤可通过一个骨窗一并切除者；（２）有较大转移瘤会引致脑干受压威胁生命者。

The clinical manifestation, pathology, diagnosis and treatment of 108 cases of brain metastases from lung cancer were reviewed. The diagnosi and surgical treatment were discussed. The patients with a single brain metastasis, which was treated by surgical excision plus postoperative whole brain radiation therapy, were located in an accesible area if the patients were in good general condition. Repeated surgical excision was indicated for recurrent single metastasis. For multiplebrain metastases, surgical excision was needed in the following conditions:(1) Two metastatic lesions could be removed through one cramal opening, (2) One of the lesions was large and threatened the life due to mass effect on the brain stem.