三维立体定向放疗联合全脑放疗对脑转移瘤的作用

摘要

目的 探讨三维立体定向放射治疗联合全脑放疗对脑转移瘤患者神经认知功能及生存质量的影响.方法 选取河南科技大学附属三门峡市中心医院肿瘤医院2012-02 2016-01收治的54例脑转移瘤患者,依据治疗方案不同分为单一组与联合组各27例.单一组实施单纯全脑放疗,于此基础上,联合组实施三维立体定向放射治疗.统计2组临床效果、不良反应情况,并对比2组治疗前后生存质量及神经认知功能变化情况.结果 2组临床总有效率相比,联合组81.49％(22/27)显著高于单一组55.56％％(15/27),差异有统计学意义(P＜0.05);2组治疗前神经认知功能评分比较差异均无统计学意义(P＞0.05);与单一组相比,治疗后联合组神经认知功能评分较高,差异有统计学意义(P＜0.05);2组治疗前各领域生存质量评分比较差异均无统计学意义(P＞0.05);与单一组相比,治疗后联合组各领域生存质量评分均较高,差异有统计学意义(P＜0.05);联合组不良反应发生率18.52％(5/27)与单一组11.10％(3/27)相比,差异无统计学意义(P＞0.05).结论 脑转移瘤患者予以全脑放疗联合三维立体定向放射治疗,肿瘤控制效果更为显著,且可改善患者神经认知功能,提高生活质量,安全性较高.%Objective To investigate the effect of three-dimensional stereotactic radiotherapy combined with whole brain radiotherapy on neurocognitive function and quality of life in patients with brain metastases.Methods Fifty-four patients with brain metastasis were selected from February 2012 to January 2016 from the Cancer Hospital of Sanmenxia Central Hospital Affiliated to Henan University of Science and Technology.The patients were divided into single group and combined group according to the treatment plan,each with 27 cases.The single group underwent simple whole brain radiotherapy,On this basis,the combined group was treated with three-dimensional stereotactic radiotherapy.The clinical effects and adverse reactions of the two groups were statistically analyzed.The quality of life and neurocognitive function were compared between the two groups before and after treatment.Results The total effective rate of the two groups were compared.The combined group 81.49％ (22/27)was significantly higher than the single group of 55.56 ％ (15/27),the difference was statistically significant (P ＜0.05).There was no significant difference in the scores of neurological cognitive function between the two groups before treatment (P＞0.05).Compared with the single group,the neurological cognitive function scores of the combined group were higher than those of the control group (P＜0.05).There was no significant difference in the quality of life scores between the two groups before treatment (P＞0.05).Compared with the single group,the quality of life scores of the combined group were higher than those of the control group (P＜0.05).There was no significant difference in the incidence of adverse reactions between the combined group (18.52 ％,5/27) and 11.10％ (3/27) in the single group (P＞0.05).Conclusion The patients with brain metastases were treated with whole brain radiotherapy combined with three-dimensional stereotactic radiotherapy.The tumor control effect was more significant.It can improve the neurological function and the quality of life.The safety is higher.