旋转式伽玛刀联合全脑放疗治疗脑转移瘤

摘要

Objective:To investigate the clinical effect of revolving type head gamma-knife stereotactic radio-surgery(SRS)combined with whole brain radiotherapy(WBRT)in treatment for brain metastases.Method:A total of 120 patients with 1-5 brain metastases were randomly divided into two groups according to admission. Experimental group(60 cases)patients were treated with whole-brain radiotherapy 30 Gy/15 f/3 w.After WBRT,revolving type head gamma-knife treatment was performed 12-16 Gy/1f(WBRT+SRS group). Control group(60 cases)patients were treated with WBRT alone 40 Gy/20 f/4 w(WBRT group). Observed the clinical effect and complications of two groups of patients,analysed the results by statistics to evaluate the 1 year local control rate and the 1 year survival rates.Result:The obtained satisfactory clinical effect in both 2 groups without serious toxity and side effect. 1 year local control rate were 83.6%and 24.3%,1 year survival rate were 64.7%and 20.1%respectively.1 year local control rate and the 1 year survival rate in the experimental group were significantly higher than those in the control group,the difference was statistically significant and there is no obvious adverse reaction(P<0.01).Conclusion:Head gamma knife stereotactic radiotherapy combined with whole brain radiotherapy is a feasible therapeutic option for patients with brain metastases. This therapy is safe and reliable,can significantly improve the 1 year local control rate and the 1 year survival rate of the disease.%　　目的：探讨头部伽玛刀联合全脑放疗治疗脑转移瘤的疗效.方法：将120例1~5个脑转移瘤患者随机(根据入院先后顺序,每组一例)分为两组,实验组60例,患者接受全脑放疗30 Gy/15 f/3 w,后加旋转式头部伽玛刀治疗12~16 Gy/1f(WBRT+SRS组)；对照组60例,患者接受全脑放疗40 Gy/20 f/4 w(WBRT组).观察两组患者的临床效果和并发症,并进行统计处理,分析两组患者的1年局部控制率和1年生存率.结果：两组患者均取得良好效果,未出现严重毒副作用；实验组和对照组1年局部控制率分别为83.6%、24.3%；1年生存率分别为64.7%、20.1%.实验组1年局部控制率和1年生存率明显高于对照组,差异有统计学意义(P<0.01),且无明显不良反应.结论：头部伽玛刀联合全脑放疗治疗脑转移瘤患者,安全有效,可明显提高脑转移瘤患者的1年局部控制率和1年生存率.