肺癌脑转移不同放射治疗方式临床分析

The effects of various radiotherapies in lung cancer with brain metastasis

目的:探讨不同放射治疗方法对肺癌脑转移瘤的疗效,并结合文献分析。方法:130例肺癌脑转移患者行放射治疗,分全脑照射组(Whole brain radiotherapyWBRT),立体定向放射治疗外科组(Stereotactic radio-surgery SRS),全脑照射+立体定向放射外科治疗外科组(WBRT+SRS)。全脑照射1.8Gy-2Gy/次,总剂量30-40/15-20天,立体定向放射治疗外科边缘剂量8Gy-22Gy,单次或分次完成;全脑照射+立体定向放射治疗外科治疗组,先WBRT2Gy-2.2Gy/次,总剂量30Gy-44Gy/3-4周,之后SRS治疗,单次靶区边缘剂量8Gy-12Gy。结果:三组病例局部控制率分别为49.9%,81.6%和85%,中位生存期分别为5个月,11个月及12.3个月。结论:对于肺癌脑转移,SRS及WBRT+SRS治疗在局部控制率和生存率上明显优于WBRT。

Objective：To investigate the effects of various radiotherapies in lung cancer with metastasis. Methods： One hundred and thirty lung cancer patients with brain metastasis were divided into three groups： whole brain radiotherapy （WBRT）, stereotactic radiosurgery （SRS）, WBRT ＋ SRS. In WBRT,single tumor target dose ranged from 1.8Gy to 2Gy in fifteen to twenty days with total dose 30Gyto 40Gy. In WBRT, surgical edge dose ranged from 8Gyto22Gy ,per fraction or dividing fraction;The dose fraction of WBRT ＋ SRS were first with WBRT 30Gy to 44Gy in 3 to 4 weeks,2 to 2.2 Gy per fraction ,then SRS with single target dose 8 to 12 Gy. Results：The response rates in three groups were 49.9%, 81.6% and 85% ;median survival were 5.0,11.0, and 12,0 month respectively. Condusion： For lung cancer with brain metastasis , SRS and WBRT ＋ SRS were better than WBRT in the response rate and median survival.