【摘要】 目的回顾性分析脑转移瘤采用单纯放射治疗(R)和放疗加化疗(R+C)的治疗效果和影响预后因素。方法对1992年8月至2004年7月,12年间收治的脑转移瘤中46例,进行回顾性观察分析。R组28例,首先行全脑放疗30～36Gy后,缩野加量至40～60Gy。R+C组18例,首先行全脑放疗30Gy后,在缩野加量的同时,加VM-26100mg+NS500ml静脉点滴,每天1次,连用3天,第4天口服Me-CCNU150～200mg,间隔6～8周重复化疗1次,共3～6周期,放疗总量仍为40～60Gy。结果大于12个月的生存率和局部控制率R+C组明显优于R组(P<0.05)。原发肿瘤控制与否及其病理类型、颅外转移与疗效有明显相关性。结论R+C治疗脑转移瘤在延长患者的生存期和局部控制方面明显优于R组。原发肿瘤控制与否及其病理类型、颅外转移对疗效有显著影响。如立体定向放射治疗(SRS)配合全脑照射,疗效会更满意。更多还原

【Abstract】 Objective To analyze the result of treatment with alone radiotherapy(R)and radiotherapy plus chemotherapy(R+C)and investigate its prognostic factors for brain metastasis retrospectively.Methods From August 1992 to July 2004 46 patients of brain metastasis were studied in 2 groups.Group R with 28 cases,whole brain irradiation were given with the dose 30～36 Gy first,then shrink the field and increase the dose to 40-60Gy.Group R+C with 18 cases,give whole brain irradiation with the dose 30Gy first,then reduce the field,in the same time,use the VM-26 100mg+N.S 500ml for iv drop,qd for 3 days,and the Me-CCNU 150mg～200mg for oral on the fourth days,6～8 week as circle,repeat for 3～6 circles,the totle dose of irradiation was still 40～60Gy.Results The survival rate and local control rate of over 12 months in group R+C was better than group R(P<0.05).The relation with efficacy and extercranium metastasis,primary tumor is controlled or no and its pathological type was obvious.Conclusion The R+C is superior to R in the prolong survival period and local control rate in treatemt for the brain metastasis.The relation with efficacy and extercranium metastasis,primary tumor is controlled or no and its pathological type is significant prognostic factor for efficacy.If stereotactic radiosurgery combined with whole brain irradiation the result shall be best.更多还原