伽玛刀分次治疗脑转移瘤的疗效评估

Evaluation of Clinical Efficacy of Fractionated Gamma Knife for the Treatment for Brain Metastasis Tumor

[目的]评价伽玛刀分次治疗脑转移瘤的临床疗效.[方法] 32例脑转移瘤患者,应用伽玛刀（陀螺旋转式钴60放射治疗系统,陀螺刀）进行分次治疗,采用每次分次剂量50%～70%等剂量曲线2.5～5 Gy,肿瘤周边总剂量30～40 Gy,治疗结束后定期复查MR并评价疗效,记录毒副作用.[结果]32例患者,随访1～15个月 ,肿瘤数量1～3个,按WHO标准评价,肿瘤消失（CR）10例,肿瘤缩小（PR）15例,稳定（SD）6例,临床症状明显好转,本组治疗的近期有效率（PR＋CR）达78.2%,一年存活率为66.7%.未出现明显的远期副作用.[结论] 与文献对比,伽玛刀分次治疗脑转移瘤局部控制率提高,不良反应减少,未出现远期毒副反应.

[Objective] To evaluate the clinical efficacy of fractionated gamma knife for the treatment of brain metastasis tumor. [Methods] Thirty two patients who suffered from brain metastasis tumor were treated with fraetionated gamma knife（cobalt 60-gyro rotating radiation therapy system, Gyro Knife）. The fractionated dose of 50- 70% isodose curve were 2.5-5Gy, and the total dose of tumor periphery were 30-40 Gy. Periodical follow up after treatment was performed with MR scan to evaluate the clinical efficacy as well as record the side effects. [Results] Thirty two patients were followed up for 1-15 months and the number of tumor in one patient was 1 to 3. According to WHO standards for the clinical evahiation, 10 cases were the complete remission（CR） of the tumor, and 15 cases were partial remission（PR）, and 6 cases were in a stable condition（SD）. The clinical symptoms in all cases were much improved. The short-term effect（PR q- CR） in this group was up to 78. 2~ and the one-year survival rate was 66.7- No obvious long-term side-effects were observed in the follow up period. [ConclusionlCompared with previous studies, fractionated gamma knife for the treatment of brain metastasis tumor has high local control rate, less ad- verse reaction and no long-term side effects.