脑转移瘤的伽玛刀放射外科疗效观察

Effect and clinical analysis of gamma knife radiosurgery for brain metastasis

目的探讨伽玛刀治疗脑转移瘤疗效及影响疗效的相关因素。方法回顾性分析采用伽玛刀治疗的139例有病理学证实的肺癌脑转移瘤患者的临床资料。结果 KPS评分1个月内达90分以上者占95%。治疗后2～3个月经MRI、CT扫描以了解肿瘤变化:完全缓解112个病灶(51%),部分缓解67个病灶(30.6%),无变化37个病灶(16.9%),进展3例占1.4%,局部控制率95%。水肿指数从治疗治疗前EI平均值为10.1±3.6降低到治疗后的4.2±2.3,显著下降(P<0.05)。生存期5～49个月,中位生存期13个月,0.5年生存率82%,1年生存率58%,2年生存率23%。至随访末时,97例患者死亡,死亡原因分析:因颅内病变进展导致死亡31例,占32%,由颅外病变恶化导致死亡66例,占68%。结论伽玛刀是治疗肺癌脑转移瘤安全有效的方法。

Objective To investigate the clinical effect of gamma knife radiosurgery for brain metastasis.Methods The clinical data of 139patients,diagnosed by pathology with brain metastasis and reated with gamma knife were analyzed retrospectively.Results KPS inreased to 90in 95%patients after one month.CR IN 112BM,PR in 67BM,and SD in 37BM with the overall response rate of 95%.EI decreasd from 10.1±3.6before treatment to 4.2±2.3（P0.05）.The median survival of 13months,sixth months survival is 82%,one year surival rate is 58%and two year survival rate is 23%。97patients died with intracranial progression in 31patiens and extracranial progression in 66patients.Conclusion Gamma knife radiosurgery for brain metastasis is a safe and effective method.