【摘要】 [目的]评价全脑放疗联合伽玛刀治疗脑转移瘤的价值。[方法]将60例脑转移瘤病人随机分为两组:全脑放疗联合伽玛刀治疗组(A组)及单纯伽玛刀治疗组(B组)。A组先全脑放疗40Gy/20F/4W后,复查颅脑MRI或CT,如果有残留,则继以伽玛刀治疗,周边剂量8Gy~26Gy,一次照射;B组单纯伽玛刀治疗,肿瘤周边剂量16Gy~32Gy,一次照射。分别对两组不同病灶数患者的近期疗效及生存率进行统计学分析。[结果]两组患者近期疗效及生存率差异无显著性;分层研究显示:单个病灶者两组生存率差异无显著性,而两个以上病灶者全脑放疗联合伽玛刀治疗的生存率高于单纯伽玛刀治疗,差异有显著性。[结论]对于单个病灶的脑转移瘤可单纯行伽玛刀治疗;而多发病灶的脑转移瘤,建议全脑放疗联合伽玛刀治疗。更多还原

【Abstract】 To assess the value of whole brain irradiation(WBI)combined with Gamma knife in treatment for brain metastases.Sixty patients were divided randomly into the WBI combined with Gamma knife treatment group(group A) and the Gamma knife treatment alone group(group B).Group A underwent whole brain irradiation with a dose of 40G/20F/4W followed by MRI or CT scans.Gamma knife treatment was performed with a circumference dose of 8Gy～26Gy by single irradiation for brain residual tumor.Group B underwent Gamma knife treatment with a circumference dose of 16Gy～32Gy by single irradiation.The short-term effect and survival rate of the two groups were analyzed according to amounts of lesion.The short-term effect and survival rate were not significantly different between the two groups.The result showed that no significant difference in survival rate of patient with single lesion between the two groups.The survival rate of patients with more than two tumor lesions treated with WBI combined with Gamma knife was significantly higher than that treated with Gamma knife alone.[Conclusion]Brain metastases with single lesion could be treated by Gamma knife alone.WBI combined with Gamma knife treatment is necessary for multiple brain metastases.更多还原