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目的:总结我院用X-刀治疗脑转移瘤的经验。方法:以Brain ScanⅡ型X-刀治疗脑转移瘤病人23例,共38个病灶。治疗计划为:病灶体积为13.40±9.35cm~3,等中心数目1至3个不等,准直仪直径为10～40mm,中心剂量为22.25±3.24Gy,肿瘤边缘剂量为15.75±2.93Gy。其中17例加作了全脑放射治疗。结果:随访8.52±3.54个月,病灶经X-刀治疗后局部控制率为89.47％。病人因脑转移瘤而产生的症状均明显改善或消失,其平均生存时间为7.88±3.24个月,加作全脑放疗者的平均生存时间明显较单纯X-刀治疗为长。未发现放射性水肿、坏死及自发性瘤内出血等严重的并发症。已死亡8例,死亡原因与X-刀听治疗的转移灶无关。结论:X-刀或其它立体定向放射神经外科是治疗脑转移瘤的良好方法,但应慎重选择适应证,加强术后处理,并结合其它治疗手段。
Objective: To summarize the experience of using X-knife in treating brain metastases in our hospital. Methods: 23 cases of brain metastases were treated with Brain Scan Ⅱ X-knife. There were 38 lesions. The treatment plan was as follows: the lesion volume was 13.40 ± 9.35cm ~ 3, the number of islets ranging from 1 to 3, the collimator diameter was 10 ~ 40mm, the center dose was 22.25 ± 3.24Gy and the tumor marginal dose was 15.75 ± 2.93Gy. Seventeen of them were treated with whole brain radiation. Results: After a follow-up of 8.52 ± 3.54 months, the local control rate of lesions after X-knife treatment was 89.47%. Patients with brain metastases symptoms were significantly improved or disappeared, the average survival time was 7.88 ± 3.24 months, plus the whole brain radiotherapy were significantly longer than the average survival time of X-knife alone. No serious complications such as radioactive edema, necrosis and spontaneous intratumoral hemorrhage were found. 8 cases have died, the cause of death and X-knife treatment of metastases has nothing to do. CONCLUSIONS: X-knife or other stereotactic radiosurgery is a good method for the treatment of brain metastases, but indications should be carefully selected to enhance postoperative management in combination with other therapies.