癌性脑膜炎的放射治疗(附17例分析)

Radiotherapy of carcinomatous meningitis:a report of 17 Cases

目的 通过对 17例癌性脑膜炎治疗效果的分析 ,探讨放射治疗对该病的治疗及预后的影响。方法 17例经临床 ,影像学或CSF细胞学检查证实的癌性脑膜炎患者。 15例行放疗 ,1例未完成治疗 ,1例因恶液质不宜放疗。结果 10例接受全脑放疗者 ,9例中枢神经系统症状及体征改善 ;4例行全脑 +脊髓节段照射 ,3例中枢神经系统及神经根表现明显改善 ,1例症状无改变。 2例经全脑脊髓照射后脑部及神经根症状均改善。脑膜CT及MRI示局部病变消失2例 ,缩小 8例 ,稳定 3例 ;脊髓CT、MRI检查示局部病变缩小 1例 ,未控 1例。照射者中位生存期 6.7个月。中断治疗患者及恶液质各 1例均在 2月内死亡。结论 对癌性脑膜炎行短程放射治疗 ,可降低治疗费用 ,缩短治疗时间 ,提高生存质量。

Objective To study the diagnosis,management and prognosis of leptomeningeal carcinomatosis.Methods 17 patients of cancerous meningitis were diagnosed by clinical symptoms,CT,MRI and cellular examination of CSF,of whom 15 cases received whole brain or central nerve system radiotherapy,one case did not finish the treatment and the other one did not receive radiotherapy because of dyscrasia.Results Of 16 cases received radiotherapy,9/15 cases neurological symptoms were mitigated.Meningeal CT or MRI showed that CR 2,PR 9,SD 3,PD 1 with a median survival time of 6.7 months.Conclusion Shortcourse radiotherapy could shorten treatment time,reduce the expense of treatment and improve life quality of patients with leptomeningeal carcinomatosis.