脑转移瘤再次放射治疗的疗效分析

Clinical analysis of reradiotherapy in treating brain metastases

目的探讨脑转移瘤患者再次放射治疗的临床疗效及安全性。方法32例脑转移瘤患者行三维适形放射治疗，放射治疗结束后对疗效和不良反应进行评价，并分析患者预后的影响因素。结果全组临床总有效率为59．4％，疾病控制率为84．4％；6个月生存率为46．9％（15／32）；1年生存率为37．5％（12／32）。放射治疗不良反应主要为白细胞和血小板下降，其中I度2例，Ⅱ度1例，未经特别处理自行缓解。未出现Ⅲ～Ⅳ度不良反应。KPS评分、年龄、原发肿瘤的控制情况、颅外转移以及脑转移的数目与脑转移瘤患者预后密切相关。结论三维适形放射治疗可以提高脑转移瘤临床总有效率，延长生存期，且不良反应较低，使用安全有效，值得临床推广应用。

Objective To investigate the clinical efficacy and safety of re radiotherapy on brain me- tastasis. Methods 32 cases admitted to our hospital with brain metastases received three-dimensional con- formal radiotherapy. After radiotherapy, the efficacy and adverse reactions were evaluated, and the factors af- fecting the prognosis were analyzed. Results The clinical total effective rate was 59.4%, disease control rate 84.4% ;6 months survival rate 46. 9% （15/32） ;the 1 year survival rate 37. 5% （12/32）. Adverse re- actions of radiotherapy were decreasement of white blood cells and platelets, mainly the type I （2 cases） and type II （ 1 cases） who were relieved without special treatment. There was no cases with grade III or IV ad- verse reaction observed. KPS score, age, primary tumor control situation, extracranial metastasis and metasta- sis to the brain and the number of brain metastasis were closely related to the prognosis. Conclusions Three dimensional conformal radiotherapy can improve the total clinical effective rate of brain metastasis pa- tients, prolong the survival time with lower adverse reactions. The therapy proved to be safe and effective, and worthy of further clinical application.