转移性脑肿瘤38例伽玛刀放射治疗临床观察.docVIP

转移性脑肿瘤38例伽玛刀放射治疗临床观察【摘要】 目的 验证伽玛刀治疗脑转移瘤的有效性和安全性。方法 脑转移瘤患者38例(70个病灶)先进行常规全脑放疗后采用杭州华源伽玛医疗设备投资有限公司生产的WB-SRS260伽玛刀立体定向适形照射转移灶。肿瘤边缘剂量2．5～5Gy/次，1次/d，5次/周，计划靶区边缘(50%的等剂量线处)总剂量32 ～ 50 Gy。结果 完全缓解（CR） 15例（39．5%），部分缓解（PR） 19例（50%）, 肿瘤好转（MR）1例（2．6%），稳定（SD）3个（7．9%），有效率为89．5%。大多数未出现严重不良反应（79%）。结论 伽玛刀治疗脑转移瘤安全有效。 【关键词】 脑转移瘤；立体定向放射治疗；伽玛刀；全脑放疗 Clinical efficacy of gamma-knife radio-surgery in the treatment of 30 patients with brain metastases and lung cancer WU Li-ping, GAO Guo-wei Dept Radiotherapy, Xinxiang Centre Hospital, Xinxiang 453000,China 【Abstract】 Objective To evaluate the efficacy and safety of gamma-knife radio-surgery in the treatment of brain and lung tumor. Methods 38 patients (70 locus) with brain metastases were treated by WB-SRS260 gamma-knife of Hangzhou gamma-knife company after regular whole brain radiotherapy(WBRT).The 50% dose curves were selected in γ-knife and the peripheral irradiation doses of the clinical planning target ranged from 2.5 Gy to 5 Gy per fraction, one fraction per day, 5 fraction per week, total dosage ranged from 32 Gy to 50 Gy. Results 38 patients were followed up. The complete response (CR) rate, partial response (PR) rate, no change (NC) rate and progression disease (PD) rate were 39.5%, 50%, 2．6% and 7．9%, respectively. The effective rate was 89．5% (CR 39．5% and PR50%). And most cases had no any side effects (79%). Conclusion Gamma knife radio-surgery in the treatment of brain metastases was effective and safe. 【Key words】 Brain metastases tumor; Stereotactic radiosurgery(SRS)；Gamma knife；Whole brain radiotherapy(WBRT). 本科自2005年11月至2007年10月共收治脑转移瘤患者38例进行放射治疗,取得了较好疗效。现报告如下。 1 材料与方法 1．1 一般资料 本组男21例,女17例,年龄30～82岁,中位年龄56岁。原发灶不明1例，原发灶明确37例：其中肺癌15例(小细胞肺癌7例,肺腺癌5例，肺鳞癌3例),乳腺癌8例,直肠癌5例, 食管癌3例,胃癌3例,肝癌2例,恶性黑色素瘤1例。所有转移灶均经CT和（或）MRI证实,多发性25例,单发性13例。所有病例有二大类症状：颅内高压症和局部症状。具体有下列一项或多项症状:头痛、头晕、恶心、呕吐、言辞不清、精神症状及肢体功能障碍,(如肢体乏力、瘫痪、抽搐等)。 1．2 放疗方法38例脑转移瘤患者首先采用6MV-X线,单次量1．8Gy～2．0Gy,1次/d,5次/周,全颅放疗30～40Gy/3～4周。全脑放疗后使用WB-SRS260型智能数控伽玛刀放疗系统。患者采用