旋转式伽玛刀联合全脑放疗治疗脑转移瘤

Revolving Type Gamma-knife Combined with Whole Brain Radiotherapy in Treatment for Brain Metastases

目的：探讨头部伽玛刀联合全脑放疗治疗脑转移瘤的疗效。方法：将120例1～5个脑转移瘤患者随机（根据入院先后顺序,每组一例）分为两组,实验组60例,患者接受全脑放疗30Gy/15f/3w,后加旋转式头部伽玛刀治疗12～16Gy/1f（WBRT＋SRS组）;对照组60例,患者接受全脑放疗40Gy/20f/4w（WBRT组）。观察两组患者的临床效果和并发症,并进行统计处理,分析两组患者的1年局部控制率和1年生存率。结果：两组患者均取得良好效果,未出现严重毒副作用;实验组和对照组1年局部控制率分别为83.6%、24.3%;1年生存率分别为64.7%、20.1%。实验组1年局部控制率和1年生存率明显高于对照组,差异有统计学意义（P〈0.01）,且无明显不良反应。结论：头部伽玛刀联合全脑放疗治疗脑转移瘤患者,安全有效,可明显提高脑转移瘤患者的1年局部控制率和1年生存率。

Objective： To investigate the clinical effect of revolving type head gamma-knife stereotactic radio-surgery （ SRS ） combined with whole brain radiotherapy （ WBRT ） in treatment for brain metastases.Method： A total of 120 patients with 1-5 brain metastases were randomly divided into two groups according to admission. Experimental group （ 60 cases ） patients were treated with whole-brain radiotherapy 30 Gy/15 f/3 w.Mter WBRT, revolving type head gamma-knife treatment was performed 12-16 Gy/lf （ WBRT ＋ SRS group ） . Control group （ 60 cases ） patients were treated with WBRT alone 40 Gy/20 f/4 w （ WBRT group ） . Observed the clinical effect and complications of two groups of patients, analysed the results by statistics to evaluate the 1 year local control rate and the 1 year survival rates.Result： The obtained satisfactory clinical effect in both 2 groups without serious toxity and side effect. 1 year local control rate were 83.6% and 24.3%, 1 year survival rate were 64.7% and 20.1% respectively.1 year local control rate and the 1 year survival rate in the experimental group were significantly higher than those in the control group, the difference was statistically significant and there is no obvious adverse reaction （P〈0.01） .Conclusion： Head gamma knife stereotactic radiotherapy combined with whole brain radiotherapy is a feasible therapeutic option for patients with brain metastases. This therapy is safe and reliable, can significantly improve the 1 year local control rate and the 1 year survival rate of the disease.