【摘要】 目的总结脑转移瘤X线立体定向放射外科(X刀)治疗的临床疗效及生存期。方法回顾性分析我院1996年3月～2008年3月X刀治疗的有完整随访结果共520例颅内转移瘤资料,其中单发转移灶336例,多发转移灶184例(2个病灶51例,3～5个病灶63例,6～10个病灶70例)。病灶直径5～35mm,平均16.4mm。治疗时平均中心剂量22Gy(20～25Gy),周边剂量12Gy(10～14Gy),覆盖病灶体积80%以上。结果520例随访8～36个月,平均20个月。术后6个月复查的CT和MRI显示,完全缓解218例(41.9%),部分缓解182例(35.0%),无变化78例(15.0%),进展42例(8.1%),病灶总控制率91.9%(478/520)。生存时间达6个月者共442例(85.0%),生存时间达12个月者共354例(68.1%),1年、3年生存率分别为40%、5.5%,中位生存期为12.6月。结论X刀治疗脑转移瘤临床疗效肯定,能够提高患者的生活质量和相对延长生存期。更多还原

【Abstract】 Objective To explore the efficacy and postoperative survival times of stereotactic radiosurgery by X-knife in the treatment of brain metastatic tumors.Methods Between March 1996 and March 2008,520 patients with brain metastatic tumors were treated in our hospital by stereotactic radiosurgery using X-knife.Among the cases,336 had single metastatic lesions,and 184 presented with multifocal tumors(2 lesions in 51 patients,3-5 lesions in 63,and 6-10 lesions in 70).The tumors sized 5 to 35 mm in diameter with a mean of 16.4 mm.Stereotactic radiosurgery was carried out in the cases with a mean central dose of 22 Gy(20 to 25 Gy),and mean marginal dose of 12 Gy(10 to 14 Gy).Over 80% of the lesions were encircled with the dosage.Results The 520 patients were followed up for 8 to 36 months(mean,20 months).CT and MRI performed in the 6th months postoperation showed complete response in 218 patients(41.9%),partial response in 182(35.0%),no response in 78(15.0%),and progressed disease in 42(8.1%).The overall control rate of the tumors were 91.9%(478/520).In this series,the 6-months survival rate was 85.0%(442/520),12-month survival rate was 68.1%(354/520),and the 1-year and 3-year survival rates were 40% and 5.5% respectively.The medium survival time was 12.6 months.Conclusions Stereotactic radiosurgery is an effective method for brain metastatic tumors.It can improve the life quality and survival time of the patients.更多还原