肺癌脑转移瘤三维适形放疗和立体定向放疗疗效的比较分析

Comparative Analysis of Curative Effect Between Three Dimensional Conformal Radiation Therapy and Stereotactic Radiation Therapy in the Treatment of Brain Metastasis from Lung Cancer

目的：分析和总结三维适形放疗与立体定向放疗在治疗脑转移瘤中的疗效。方法回顾性分析2009年11月～2011年11月于我院行全脑放疗后行三维适形放疗或立体定向放疗的60例肺癌脑转移患者的放疗资料、随访资料及影像学资料，比较两种放疗方式的疗效。结果本组含1～2个脑转移灶的患者共21例，12例行三维适形放疗，9例行立体定向放疗，两组患者的中位生存期、有效率和1年生存率分别为12月、83.3%、58.3%和14月、88.9%、66.7%。脑转移灶数≥3的患者共39例，17例行三维适形放疗，22例行立体定向放疗，两组的中位生存期、有效率和1年生存率分别为7月、58.8%、41.2%和13月、81.8%、68.2%。在脑转移灶数≥3的患者中，立体定向放疗组的中位生存期、有效率和1年生存率都明显优于三维适形放疗组（P＜0.05）。结论对于多发性脑转移瘤患者，立体定向放疗较三维适形放疗更有效。

Objective To analyze and conclude the efficacy of three dimensional conformal radiation therapy （3D-CRT） and stereotactic radiation therapy （SRT） in the treatment of brain metastasis. Methods Data of 60 patients who suffered from lung cancer with brain metastasis were retrospectively analyzed. From November 2009 to November 2011, these patients were all treated in our hospital either by SRT or 3D-CRT after whole brain radiotherapy. The radiotherapy data, follow-up data and imaging data of the patients were analyzed to compare the efifcacy of the two therapies. Results Among 21 patients with one or two brain metastases, 12 patients went through 3D-CRT and 9 went through SRT. The median survival time, effective rate and one year survival rate of these two groups are 12 months, 83.3%, 58.3%and 14 months, 88.9%, 66.7%, respectively. Among 39 patients with more than three brain metastases, 17 patients went through 3D-CRT and 22 went through SRT. The median survival time, effective rate and one year survival rate of the two groups are 7 months,58.8%,41.2%and 13 months,81.8%,68.2%, respectively. So to patients with more than three brain metastases, median survival time, effective rate and one year survival rate of SRT group were signiifcantly better than those of 3D-CRT group （P〈0.05）. Conclusion For patients with multiple brain metastases, SRT was more effective than 3D-CRT.