伽玛刀治疗43例非小细胞肺癌脑转移瘤的疗效分析

摘要

目的：评价伽玛刀立体定向放射治疗非小细胞肺癌（NSCLC）脑转移瘤的疗效。方法回顾性分析接受伽玛刀治疗的43例非小细胞肺癌合并1~4个脑转移瘤患者的临床资料，根据转移灶情况确定治疗剂量，取50%~60%的等剂量曲线覆盖靶区，伽玛刀治疗剂量为16~20 Gy，评估局部控制率和生存率。结果43例患者中，完全缓解9例（20.9%），部分缓解23例（53.5%）例，疾病稳定10例（23.3%），有效率74.4%（32/43）；6个月总的肿瘤局部控制率为90.7%（39/43）。全组患者的中位生存期为11个月（95%可信区间为7.2~14.8），6个月、1和2年总生存率分别为81.4%、46.5%和20.9%。未发现放射治疗相关致死病例。结论伽玛刀治疗非小细胞肺癌脑转移瘤疗效确切、安全。%Objective To evaluate the efficacy of patients with non-small cell lung cancer (NSCLC) and one to four lesions of brain metastasis (BM) undergoing gamma knife stereotactic radiotherapy.Methods Fourty-three patients with NSCLC and one to four BM lesions treated by gamma knife were eligible for this retrospective analysis. The dosage were established on the BM lesions. The dose carve was 50%-60% and covered the target volume. The dose of gamma kinfe was 16-20 Gy. Evaluate the local control rate and the overall survival.Results Of 43 patients, 9(20.9%) achieved complete response, 23(53.5%) achieved partial response, 10(23.3%) achieved stable disease. The overall response rate was 74.4%(32/43), and the six-month overall tumor control rate was 90.7%(39/43). The median survival time was 11 months(range: 3-30 months; 95% conifdence interval: 7.2-14.8). The six-month, one-year and two-year overall survival rates were 81.4%, 46.5% and 20.9%. No severe adverse events and toxicity were observed.Conclusion For patients with non-small cell lung cancer and brain metastasis treated by gamma knife SRT is safety and effective.