脑转移瘤62例临床分析

Clinical study of metastatic brain tumors: A review of 62 cases.

目的 探讨脑转移瘤 (BM)的诊断和治疗方法。方法 采用CT、MRI诊断BM 62例 ,其中 8例术前误诊。 47例单发BM全切 ,15例多发BM行大瘤切除。术后 5 5例行综合治疗。结果 本组 5 5例生存至少半年。 3 5例随访 8个月至6年半 ,存活期 8～ 75个月 ,平均 2 7个月。其中手术加放疗组 ,平均存活 11个月 ;手术加放疗及化疗组 ,平均存活 2 9个月 ;手术加γ 刀及化疗组 ,平均存活 14个月。未查到原发灶的单发BM组 ,平均存活 3年 ;有明确原发灶及多发BM ,平均存活14个月。术后死亡 7/62。结论 对有手术适应证的BM ,积极手术治疗 ,术后综合治疗能延长BM生存期 ,最佳治疗方案为手术加放疗和化疗。

Objective To investigate the diagnosis and treatment of patients with brain metastases(BM). Methods We used CT and MRI to diagnose BM in this study. Of the 62 patients studied, preoperative misdiagnosis was found in 8. Tumours were totally resected in 47 patients with single BM. The main tumors were resected in 17 patients with mutiple BM. Fifty five patients underwent combined therapy(radiotherapy, chemotherapy or γ knife)after operation. Results Fifty five patients survived at least 6 months. Thirty five patients were followedup, of whom the survival ranged 8-75 months(average 27 months). The mean survival was 11 months in patients treated by operation and radiotherapy, 29 months in patients treated by operation, radiotherapy and chemotherapy, and 14 months in those treated by operation, γ knife and chemotherapy. Patients with single BM and unknown primary cancers survived a average of 3 years, and patients with mutiple BM and known primary cancer survived a average of 14 months. Seven cases died during perioperative period. Conclusions Brain CT, MRI examinations play an importment roles in the diagnosis, evaluation of the effect of treatment and the follow up study of BM. Active surgical treatment should be performed in the appropriate cases. Surgery plus postoperative radiotherapy and chemotherapy confers the best chance of survival.