| 射波刀治疗脑干转移瘤的疗效与预后分析 |
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| 引用本文： | 刘群,王晓光,尹强,董洋,李丰彤,袁智勇.射波刀治疗脑干转移瘤的疗效与预后分析[J].中国肿瘤临床,2019,46(19):1003-1007. |
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| 作者姓名： | 刘群 王晓光 尹强 董洋 李丰彤 袁智勇 |
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| 作者单位： | 天津医科大学肿瘤医院脑系肿瘤科, 国家肿瘤临床医学研究中心, 天津市肿瘤防治重点实验室, 天津市恶性肿瘤临床医学研究中心(天津市 300060) |
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| 摘 要： | 目的 评价射波刀治疗脑干转移瘤的疗效和安全性。 方法 回顾性分析2013年1月至2018年1月于天津医科大学肿瘤医院接受射波刀治疗的49例患者，共55个脑干转移瘤病灶，总结患者治疗后总生存时间和局部控制率。分析性别、年龄、肿瘤部位、肿瘤大小、原发灶病理、KPS评分、术前是否行全脑放疗等对射波刀治疗脑干转移瘤预后的影响。 结果 中位肿瘤体积为1.96（0.1~15.6）cm3，总剂量8.0~40.0 Gy，1~5次/d，中位单次等效处方剂量（α/β=10）为18.2（8.0~23.7）Gy。中位最大单次等效剂量为25.2（11.8~37.4）Gy。局部控制率87.3%，15个病灶完全缓解（complete response，CR），27个病灶部分缓解（partial response，PR），6个病灶病变稳定（stable disease，SD）。中位生存时间为14（1~43）个月，中位无进展生存期为17.4个月。治疗后半年、1年、2年的生存率分别为75.5%、55.1%、28.6%。 结论 射波刀治疗脑干转移瘤安全有效，射波刀无框架，患者接受度好，分次照射可以用于治疗体积较大的肿瘤，脑干放射性反应发生率低。
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| 关 键 词： | 射波刀 放射外科 脑干 脑转移 生存时间 |
| 收稿时间： | 2019-09-04 |
Efficacy and prognostic analysis of CyberKnife radiosurgery for brainstem metastases |
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| Affiliation: | Department of Neurosurgery and Neuro-oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China |
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| Abstract: | Objective To evaluate the efficacy and safety of CyberKnife radiosurgery for the treatment of brainstem metastases. Methods We retrospectively reviewed the medical records of 55 brainstem metastases in 49 consecutive adult patients treated with CyberKnife at Tianjin Medical University Cancer Hospital between January 2013 and January 2018. Overall survival and local control rate after treatment were analyzed. The variables included sex, age, tumor location, tumor size, resection extent, primary pathology, KPS score and with or without whole brain radiotherapy. Results The median size of the treated lesions was 1.96 (0.1-15.6) cm3. The prescribed dose was (8-40) Gy, delivered by 1-5 days. The median single session equivalent dose (α/β=10) was 18.2 (8-23.7) Gy. The median maximum single session equivalent dose was 25.2 (11.8-37.4) Gy. Of 55 treated lesions, the local control rate was 87.3% (15 CR, 27 PR and six SD). The median survival time was 14 months and the median progression-free survival time was 17.4 months. The overall survival ratios after treatment at 0.5, 1, and 2 years were 75.5%, 55.1%, and 28.6%, respectively. Conclusions CyberKnife radiotherapy is a safe and effective treatment for patients with brainstem metastases. CyberKnife allows for hypofractionation or multisession treatments, which may reduce complications and adverse effects involving surrounding brain tissue while enabling the treatment of larger lesions. |
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