伽玛刀联合立体定向穿刺引流治疗囊性脑转移瘤疗效观察

Clinical observation in cystic brain metastases treated by gammaknife combined with stereotactic puncture drainage

目的探究伽玛刀联合立体定向穿刺引流治疗囊性脑转移瘤患者疗效及术后中、远期疗效。方法选取2008年5月—2014年6月郑州人民医院42例囊性脑转移瘤患者,依据治疗方案不同分组,各21例。对照组予以立体定向穿刺引流治疗,研究组予以立体定向穿刺引流+伽玛刀治疗。观察统计两组治疗效果,随访3年,统计两组中、远期生存率。结果研究组疾病缓解率57.14%(12/21)、局部控制率85.71%(18/21)均高于对照组23.81%(5/21)、52.38%(11/21),差异有统计学意义(P<0.05);两组随访1年生存率相比,差异无统计学意义(P>0.05);研究组随访2年生存率76.19%(16/21)、3年生存率61.90%(13/21)均高于对照组42.86%(9/21)、28.57%(6/21),差异有统计学意义(P<0.05)。结论对囊性脑转移瘤患者联合采用伽玛刀、立体定向穿刺引流治疗,可一定程度提高治疗效果,且患者中、远期生存率较高。

Objective To explore the clinical observation in cystic brain metastases treated by gamma knife combined with stereotactic puncture drainage. Methods Forty-two patients with cystic brain metastases treated in our hospital from May 2008 to June 2014 were selected and divided into two groups（ each 21 cases） according to the different treatment. The control group was treated with stereotactic puncture drainage. The study group was treated with gamma knife combined with stereotactic puncture drainage. The two groups were observed and treated for 3 years. The survival rate of the two groups was calculated. The treatment effect of them were observed and the patients were followed up for 3 years.Then make statistics of mid-term and long-term survival rate of the two groups. Results The disease remission rate of the study group was 57. 14%（ 12/21） and the local control rate was 85. 71%（ 18/21）,higher than those of the control group（ 23. 81%,5/21） and 52. 38%（ 11/21）（ P〈0. 05）. There was no significant difference in the 1-year follow-up survival rate between the two groups（ P〉0. 05）. The 2-year survival rate of the study group was 76. 91%（ 16/21）,and the 3-year survival rate was 61. 90%（ 13/21）,higher than of the control group 42. 86%（ 9/21） and28. 57%（ 6/21）（ P〈0. 05）. Conclusion Gamma knife combined with stereotactic puncture drainage on cystic brain metastases can improve the treatment effect in a certain degree,and the mid-term and long-term survival rate of patients with is higher.