肺癌脑转移治疗ppt课件.ppt

杭州市第一人民医院医疗集团杭州市肿瘤医院浙江省医学科学院肺癌研究所;肺癌脑转移;PART 1： PCI in SCLC;局限期SCLC;PCI的剂量效应;PCI 01-EULINT1;BM;RTOG 0212;RTOG 0212;广泛期SCLC;EORTC Study;Prophylactic cranial radiotherapy: Parallel opposed fields should be utilized to encompass the whole brain. The filed edges should be at least 1 cm from the outer skull margin. The recommended dose is 25 Gy in 10 fractions or 30 Gy in 15 fractions. For extensive-stage patients,20Gy in 5 fractions may be considered.;PART 2： PCI in NSCLC;NSCLC患者PCI相关问题;NSCLC脑转移高危患者;脑转移发生风险预测分子标志物;治疗方式对脑转移发生的影响;脑转移出现的时间;SWOG studies;PCI用于NSCLC：非随机临床研究;PCI用于NSCLC：随机临床研究;German Multicenter Randomized Trial;German Multicenter Randomized Trial;RTOG 0214;RTOG 0214 Results;PART 3： Effects of PCI on Neurocognitive Functions;PART 4： 脑部损伤可能机制;Sophisticated Cranial Irradiation Techniques to Avoid Neurocognitive Toxicity;Sophisticated Cranial Irradiation Techniques to Avoid Neurocognitive Toxicity;保护性药物—RTOG 0614;Unlike for small cell lung cancer, prophylactic cranial irradiation (PCI) has not been shown to improve survival in locally advanced NSCLC, but it significantly reduces brain metastases. In addition, it causes significant decline in memory but not in global cognitive function or quality of life. PCI is generally not recommended, but its relative risks and potential benefits should be considered on an individual patient basis。;杭州市第一人民医院集团