【摘要】 目的　本研究旨在探讨伽玛刀 ( gammakniferadiosugery ,GKS)治疗多发性脑转移瘤 (multi plebrainmetastases,MBM )的疗效及影响治疗效果的相关因素。方法　回顾性调查四年内GKS治疗的61例MBM患者 ,治疗病灶共 1 89个。患者平均年龄 5 7岁 ,平均术前卡氏评分 85分。平均MBM转移间隔时间 4 1个月。通过Cox多元回归分析影响生存时间的 8种因素。统计学有显著性差异P <0 0 5。结果　 61例MBM患者术后平均生存时间 8 6个月。统计分析显著影响生存时间的几个因素 :1 )治疗前卡氏评分 (Ρ =0 0 0 2 0 ) ;2 )MBM转移间隔时间 (Ρ =0 0 1 74) ;3)系统性疾患的控制 (P <0 0 0 0 1 ) ;4)年龄 (Ρ=0 0 0 60 )。是否结合全脑放射治疗 (wholebrainradiationtherapy ,WBRT)与生存时间延长没有相关性。结论　GKS治疗MBM能有效地控制局部病变 ,提高患者生存质量。MBM的早期发现、术前卡氏评分 >70 %和系统性疾患有效地治疗能延长患者的生存时间。GKS可以成为MBM的首选治疗。更多还原

【Abstract】 Objective This study was performed to examine the efficacy of gamma knife radiosurgery (GKS) for treating multiple brain metastases(MBM) and evaluate prognostic factors affecting long-term patients survival.Methods A retrospective review of 61 patients who had undergone GKS to treat a total of 189 metastases was performed.The study population had a median age of 57 years, a median Karnofsky Performance Score(KPS) of 85% before GKS and a median time from intial cancer diagnosis to MBM diagnosis of 4.1 mounths.The Cox regression model was used to study the effects of multiple variate(8 factors) on patient survival.Statistical significance was defined as P<0.05.Results overall survival time after GKS was 8.6 months. In multivatiate analyses ,factors significantly affecting survival included:1)preoperative KPS(P=0.0020);2)time from intial cancer diagnosis to multiple brain metastases diagnosis(P=0.0174);3)active systemic disease (P<0.001); 4) age (P=0.0060).Whole brain radiation therapy did not correlate with extended patients survival time. Conclusion GKS for MBM affords effctive local tumor control in approximately 87% of patients and improves patients quality of live. Early detection of brain metastases, preoperative KPS>70% and aggressive treatment of systemic disease can offer patients an extended survival.更多还原