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目的 探讨影响伽玛刀治疗脑转移瘤治疗效果的因素。方法 用伽玛刀治疗脑转移瘤 2 72例共 396个病灶。中心剂量 2 5～ 70Gy ,周边剂量 1 0～ 35Gy;靶点数 1～ 1 1个。并对肿瘤体积、数目、照射剂量、原发灶控制和全脑放疗等影响疗效因素进行统计分析。结果 本组病例随访 1 0～ 46个月 ,平均 2 4个月。 396个病灶完全缓解 32 6个 (82 3 % ) ,部分缓解 38个 (9 5 % ) ,无变化及进展 32个 (8 2 % ) ,平均生存期 (1 3 6± 7 9)个月。原发灶控制好者、伽玛刀治疗前后结合放疗、化疗者 ,其生存期较长。结论 伽玛刀是治疗脑转移瘤安全可靠的手段之一。并发症少、有效率高。伽玛刀治疗脑转移瘤的疗效主要与病灶体积、周边剂量等密切相关。肿瘤体积小于 1 5cm3,周边剂量大于 1 8Gy时 ,完全缓解率较高。
Objective To investigate the factors affecting the therapeutic effect of Gamma Knife on brain metastases. Methods Gamma knife treatment of brain metastases 2 72 cases a total of 396 lesions. Center dose 25 ~ 70Gy, peripheral dose 10 ~ 35Gy; target number 1 ~ 1 1. The effects of tumor volume, number, irradiation dose, primary tumor control and whole brain radiotherapy were analyzed statistically. Results The patients were followed up for 10 ~ 46 months, an average of 24 months. There were 326 lesions (82.3%) in 396 lesions, 38 lesions (85%) partially mitigated, 32 lesions (82%) showed no change and 32 (32.2%) progression, and the mean survival time was (136 ± 7 9) months. Good control of the primary stove, gamma knife before and after treatment with radiotherapy and chemotherapy, the longer survival. Conclusion Gamma knife is one of the safe and reliable methods to treat brain metastases. Less complications, high efficiency. Gamma knife treatment of brain metastases mainly with the lesion volume, peripheral dose and other closely related. Tumor volume less than 1 5cm3, peripheral dose greater than 18Gy, the higher complete remission rate.