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目的 :探讨脑转移瘤的立体定向放射治疗的方法 ,临床结果。方法 :采用单纯 SRS治疗颅内转移瘤 33例 ,SRS+ WBRT治疗 42例 ,31例行单纯全脑放疗。单纯 SRS治疗的剂量为 14～ 2 2 Gy/单次 ,SRS+ WBRT则在单次 SRS后在行全脑放疗 30～ 40 (y) 3～ 4周 ,单纯 WBRT治疗剂量 40～ 5 0 Gy/4～ 5周。结果 :经 2～ 3年随访 ,SRS组 33例 PR+ CR局部控制率 87.8% ,一年生存率 75 .8% ,两年生存率 45 .5 % ;SRS+ WBRT组 41例 ,CR+PR92 .9% ,一年生存率 88.1% ,两年生存率 47.6 % ;两组对照无显著差异 (P>0 .10 ) ,但无对照有显著差异 (P<0 .0 5 ) ,WBRT组 31例 ,CR+ PR87.1% ,两年生存率 2 5 .8% ,与 SRS+ WBRT组对照无显著差异 (P>0 .10 ) ,瘤生存率分别为 48.4 ,71.4 ,两组一年生存率 5 4.8 ,与 SRS+ WBRT组对照有显著差异 (P<0 .0 0 5 )。平均生存时间 SRS、SRS+ WBRT、WBRT分别为 11月、14月、8月 ,经 t检验 :SRS组与 SRS+ WBRT组相差不明显 (P>0 .10 ) ,SRS+ WBRT与 WBRT组相差明显 (P<0 .0 1)。结论 :立体定向放射外科治疗颅内转移瘤的疗效比传统外科手术、外照射好 ,是一种方法简单的治疗手段。早期脑转移瘤的 SRS治疗和全脑放疗可以提高患者生存时间和生存质量
Objective: To investigate the methods and clinical results of stereotactic radiotherapy for brain metastases. Methods: 33 cases of intracranial metastases were treated with SRS alone, 42 cases were treated with SRS + WBRT and 31 cases were treated with whole brain radiotherapy alone. The dose of SRS alone was 14-2 2 Gy / SRS + WBRT after single SRS for 30-40 (y) for 3 to 4 weeks, and the WBRT alone dose was 40-5 0 Gy / 4 ~ 5 weeks. Results: After 2 to 3 years of follow-up, the PR + CR local control rate was 87.8%, the one-year survival rate was 75.8% and the two-year survival rate was 45.5% in SRS group, 33 cases in SRS + WBRT group and CR + PR92.9 %, The one-year survival rate was 88.1% and the two-year survival rate was 47.6%. There was no significant difference between the two groups (P> 0.05), but there was no significant difference between the two groups (P <0.05) CR + PR 87.1%, two-year survival rate 25.8%, no significant difference with SRS + WBRT group (P> 0.10), the tumor survival rates were 48.4, 71.4, two groups one-year survival rate of 5 4.8, there was significant difference with SRS + WBRT group (P <0.05). The mean survival time was SRS, SRS + WBRT and WBRT in November, 14 and August respectively. There was no significant difference between SRS group and SRS + WBRT group (P> 0. 10) <0 .0 1). Conclusion: Stereotactic radiosurgery for the treatment of intracranial metastases has better curative effect than traditional surgery and external irradiation. It is a simple method of treatment. Early brain metastases SRS treatment and whole brain radiation therapy can improve the survival time and quality of life of patients