摘要
［目的］探讨不同放射治疗方法对肺癌脑转移的疗效。［方法］１７６例有病理学证实的肺癌脑转移患者分为４组：单纯全脑放疗组(WBRT)、全脑放疗加立体定向放射外科(WBRT＋SRS)，单纯立体定向放射治疗(SRT)，全脑放疗加立体定向放射治疗(WBRT＋SRT)。SRS治疗组，单次靶区平均周边剂量８Gy～２０Gy，总剂量２０Gy～３２Gy；SRT治疗组，单次靶区平均周边剂量２Gy～５Gy，总剂量２５Gy～６０Gy；WBRT组，１．８Gy～２Gy／次，总剂量３０Gy～４０Gy。［结果］４组的局部控制率分别为４７．１％、８７．７％、８６．５％、７８％；中位生存期分别为５．０、１１．０、１１．５、１０．０个月；局部无进展生存期分别为３．３３、８．３３、９．３３、７．６７个月；颅脑无新病灶生存期分别为４．１１、８．５７、９．０３、６．１２个月。单纯全脑放疗组死于脑转移的占５７．６％，较其他３组高。而全脑放疗加立体定向放射外科组的晚期放射反应的发生率为１２．２％，较其它组高。［结论］肺癌单发脑转移瘤患者的最佳治疗方式是单纯立体定向放射治疗。多发脑转移，全脑放疗加立体定向放射治疗(WBRT＋SRT)在提高生存率以及减少并发症方面优于其他治疗方法。
To investigate the prognostic factors and the effects of various radiotherapies in lung cancer with brain metastasis.One hundred and seventy-six lung cancer patients with brain metastasis pathologically proved were divided into four groups:Whole brain radiotherapy(WBRT)alone,stereotactic radiosurgery(SRS)combined with WBRT,stereotactic radiotherapy(SRT)combined with WBRT,and stereotactic radiotherapy(SRT)alone.In stereotactic radiosurgery(SRS)group,single tumor target dose ranged from8Gy to20Gy in1to3fractions with total dose20Gy to32Gy.In stereotactic radiotherapy(SRT)group,single tumor target dose ranged from2Gy to5Gy in5to30fractions with total dose25Gy to60Gy.The dose fraction of whole brain radiotherapy was30Gy to40Gy in18to25fractions,1.8Gy～2Gy per fraction.The response rates in four groups were47.1%,87.7%,86.5%,78%;median survival were5.0,11.0,11.5,10.0months respectively;the median of progression free survival(PFS)was3.33,8.33,9.33,7.67months;the median survival without new brain metastasis was4.11,8.57,9.03,6.12months respectively.There were57.6%patients in WBRT failed due to brain metastasis,the difference to the other3groups was statistically significant(P<0.05).The long term complication rate in stereotactic radiosurgery(SRS)combined with WBRT group was12.2%,the difference was statistically significant compared with other3groups.[Conclusion]SRT alone is the optimal treatment for lung cancer with single brain metastasis.For multi-metastasis of brain,SRT combined with WBRT is better than other treatments,not only in improving survival,but also in reducing complications.
出处
《肿瘤学杂志》
CAS
2003年第3期153-157,共5页
Journal of Chinese Oncology
关键词
肺肿瘤
脑肿瘤
肿瘤转移
透射疗法
立体定向放射外科
立体定向放射治疗
疗效
lung neoplasms
brain neoplasms
neoplasm metastases
radiotherapy
stereotactic radiosurgery
stereotactic radiotherapy
efficacy
