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目的 :分析用 X线立体定向放射治疗 (stereotactic radiotherapy,SRT,简称 X-刀 )颅脑肿瘤的近期疗效 ,对治疗后的患者进行跟踪随访 ,并进行阶段性工作总结回顾。方法 :10 0例脑肿瘤患者 ,原发肿瘤 4 2例 ,转移性肿瘤5 8例 ,以 CT、MR和 DSA图像资料为定位依据 ,用德国 Brain L AB公司 Brain Scan治疗计划系统设计三维治疗方案 ,西门子 Mevatron MD- 2型直线加速器旋转照射。结果 :10 0例患者近期均取得满意效果。以 Karnofsky评分标准评价 ,临床症状有明显改善 ,SRT治疗后 1周～ 3周临床症状改善率为 83 % ,肿瘤局部控制率为 97.4 4% ,肿瘤消失率3月、6月、12月分别为 2 7%、5 4 %、85 % ,总有效率为 98.73 %。SRT加全脑放疗 79例 ,SRT剂量为 16Gy～ 3 0 Gy,每周 2次 ,全脑放疗 3周～ 4周 / 3 0 Gy～ 4 0 Gy。 2 1例仅应用了 SRT治疗。 5 8例脑转移瘤患者中位生存时间为 11个月 ,1年生存率为 75 .86%。 1.5年生存率为 4 1.3 8%。结论 :SRT治疗颅内肿瘤 ,跟踪观察发现 ,只要严格掌握适应证 ,精确定位 ,精密计划 ,精确摆位 ,精心操作 ,SRT是一种安全、高效、无痛苦的治疗脑肿瘤的方法。它可起到改善临床症状 ,提高生活质量 ,延长生存时间的作用。
OBJECTIVE: To analyze the short-term curative effect of stereotactic radiotherapy (SRT) for craniocerebral tumor and to follow up the patients after treatment and to review the phased work. Methods: 100 cases of brain tumor, 42 cases of primary tumor and 58 cases of metastatic tumor were studied. The CT, MR and DSA images were used as the basis for the data. The brain scan planning system of Brain L AB in Germany was used to design three-dimensional treatment plan , Siemens Mevatron MD-2 linear accelerator rotation irradiation. Results: All the 100 patients achieved satisfactory results recently. According to the Karnofsky score, clinical symptoms improved significantly. The improvement rate of clinical symptoms was 83% at 1 week to 3 weeks after SRT treatment, and the local control rate of tumor was 97.4%. The tumor disappearance rate in March, June and December were 27%, 54%, 85%, the total effective rate was 98.73%. SRT plus 79 cases of whole brain radiotherapy, SRT dose of 16Gy ~ 30 Gy, twice a week, whole brain radiation for 3 weeks to 4 weeks / 30 Gy ~ 40 Gy. Only one case of SRT was treated in 21 cases. Fifty-eight patients with brain metastases had a median survival time of 11 months and a one-year survival rate of 75.86%. 1.5 year survival rate of 4 1.3 8%. Conclusion: SRT is a safe, effective and painless treatment of brain tumors as long as SRT is used to treat intracranial tumors. Follow-up observation shows that as long as indications, precise positioning, precise planning, precise positioning and meticulous operation are taken, SRT is a safe and effective method. It can play a role in improving clinical symptoms, improving quality of life, and prolonging survival time.