脑转移瘤的X刀治疗与手术治疗疗效比较分析

Comparison of X-knife Radiotherapy and Surgery in the Treatment of Brain Metastases

目的 :探讨X刀在脑转移瘤治疗中的临床价值。方法 :回顾分析X刀治疗的 30例脑转移瘤患者 ( 4 1个病灶 ) ,脑转移瘤直径 ( 2 .0 7± 1.7)cm ,平均剂量 2 2Gy ,肿瘤中心剂量 ( 2 8± 8)Gy ,边缘剂量 ( 16± 4 )Gy。比较分析手术加全脑放射治疗 2 6例 ,直径 ( 3.0 7± 0 .7)cm ,平均放疗剂量 4 6Gy。结果 :X刀治疗组 1年生存率 53% ,手术加全脑放疗组 4 3% ,1年后局部肿瘤控制率分别为 83%和 75% ,1年后因神经系统疾患死亡率分别为 39%和 4 1%。结论 :X刀是一种安全、有效和微侵袭的治疗方法 。

Objective To explore the clinical value of X ray knife in the treatment of brain metastases.Methods 30 patients with brain metastases of 41 lesions treated by X ray knife were analysed retrospectively,the diameters of the brain metastases were(2.07±1.7)cm,the mean dose given by X ray knife was 22 Gy, the centraldoses were(28±8)Gy,and the peripheral doses were(16±4)Gy.26 patients with brain metastases received surgical resection combined with whole brain radiotherapy were analysed comparatively,the diameters of the lesions in the latter group were(3.07±0.7)cm,and the mean whole brain radiation dose was 46 Gy.Results The 1 year survival rate of patients in X ray knife group was 53%,and 43% in the surgery group ( P =0.19).The 1 year local tumor control rates were 83% and 75% in the two groups,respectively ( P =0.49).The 1 year neurological disease specific death rates were 39% and 41%,respectively.Conclusions X ray knife is a safe,effective and minimally invasive treatment method for the small brain metastases.