肺癌脑转移瘤对地塞米松加甘露醇治疗的反应性与伽玛刀治疗效果的关系.doc

肺癌脑转移瘤对地塞米松加甘露醇治疗的反应性与伽玛刀治疗效果的关系 肺癌脑转移瘤对地塞米松加甘露醇治疗的反应性与伽玛刀治疗效果的关系 作者：沈光建，　 许民辉， 邹咏文， 耿明英， 李飞鹏 作者单位：中国人民解放军第三军医大学大坪医院野战外科研究所神经外科， 重庆 【摘要】 目的 探讨肺癌脑转移瘤对合并使用地塞米松 （Dexamethasone，DXT） 及甘露醇 （Mannitol，MT） 的反应性与伽玛刀治疗效果的关系。 方法 回顾性分析37例肺癌脑转移瘤病人的伽玛刀治疗情况。根据对DXT+MT治疗的反应性，将病人分为两组，比较两组病人的伽玛刀治疗效果。 结果 24例 （65%） 对DXT+MT治疗反应良好。伽玛刀治疗后，平均随访6.7个月 （3~13个月），肿瘤生长得到有效控制32例 （87%），其中23例对DXT+MT治疗反应良好。统计分析显示：肿瘤生长控制率在反应良好组中明显较高。 结论 在肺癌脑转移瘤伽玛刀治疗适应证选择和预后判定中，对DXT+MT治疗的反应性可视为一个粗略标准。 【关键词】 肿瘤转移； 地塞米松； 甘露醇； 放射外科手术 The relationship between the reactivity to DXT+MT and the efficacy of Gamma knife radiosurgery for brain metastases from lung cancer SHEN Guangjian, XU Minhui, ZOU Yongwen, et al. Department of Neurosurgery, Institute of Battle Surgery, Daping Hospital, The Third Military Medical University, Chongqing 400042, China Abstract: Objective To explore the relationship between the reactivity to dexamethasone (DXT) combined with mannitol (MT) and the efficacy of Gamma knife radiosurgery for metastases from lung cancer. Methods Thirty-seven patients harbored metastases from lung cancer treated with Gamma knife were retrospectively reviewed. Based on the reactivity to DXT+MT, these patients were divided into two groups. The Gamma knife radiosurgical outcome was compared between the two groups. Results Of 37 the patients, 24 (65%) showed good response to DXT+MT. At a followed-up of median 6.7 months (3-13 months) after Gamma knife radiosurgery, 32 (87%) patients showed effective tumor control, and 23 were of good response to DXT+MT. Statistical analysis revealed that the tumor control rate was significantly higher in the group with good response to DXT+MT. Conclusion Reactivity to DXT+MT can be regarded as a rough criterion that determines the choice and prognosis of Gamma knife radiosurgery for metastases from lung cancer. Key words: neoplasm metastasis; dexamethasone; mannitol; radiosurgery 临床发现，对合并使用地塞米松 （Dexamethasone，DXT） 及甘露醇 （M