脑转移瘤适形放疗疗效与预后分析

目的:探讨脑转移瘤适形放疗的疗效及预后因素。方法:40例脑转移瘤患者均接受了颅脑放射治疗。脑转移瘤数>2个者全脑放疗DT40～46Gy/(20～23)次;≤2个者全脑放疗DT40Gy/20次后,局部三维适形加量至DT54～60Gy/27～30次;孤立脑转移瘤者病灶直接采用三维适形放疗至DT54～60Gy/(27～30)次。其中34例接受了放化疗综合治疗。多因素分析采用Cox比例风险模型。结果:40例患者临床症状缓解率达92.5%(37/40),总有效率(RR)为62.5%(25/40),临床疾病控制率(CBR)达97.5%(39/40)。颅内中位局部控制时间为7.2个月,颅内6个月及1年局部控制率为47.5%、10.0%。中位生存期为10.5个月,6个月、1年及2年生存率为65.0%、25.0%和5.0%。放化疗综合治疗者生存期较单纯放疗者有延长趋势,但差异无统计学意义,P=0.290。Cox多因素分析结果表明,KPS体力评分、颅外原发灶控制情况是脑转移瘤适形放疗疗效的独立预后因素,P<0.05。结论:脑转移瘤患者适形放疗可明显缓解临床症状,提高生活质量,并显著延长生存期。体力状况、颅外原发灶控制情况是脑转移瘤适形放疗疗效的独立预后因素。

Conformal radiotherapy and prognosis of patients with brain metastases

OBJECTIVE: To evaluate the efficacy of conformal rediotherapy on brain metastases,and investigate prognostic factors.METHODS: All the 40 patients were treated with intracranial radiotherapy.The patients with more than two brain lesions received whole brain radiotherapy to DT 40-46 Gy/(20-23) fractions,while the dose for the ones with one or two lesions was boosted to DT 54-60 Gy/(27-30) fractions by three dimentional conformal radiotherapy(3D-CRT) after whole brain radiotherapy to DT 40 Gy/20 fractions.The ...