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目的探讨伽玛刀治疗脑转移瘤的近期临床疗效及不良反应。方法选择脑转移瘤患者48例(108个病灶)采用伽玛刀治疗,肿瘤周边剂量14~21Gy,平均18Gy;中心最大剂量32~40Gy,平均35.4Gy。结果对48例患者伽玛刀治疗后进行临床随访,随访时间为1~27个月,平均10个月,完全缓解8例(16.7%),部分缓解26例(54.2%),无变化10例(20.8%),进展4例(8.3%),肿瘤局部控制率为91.7%(44/48)。有神经系统症状33例患者,神经症状完全缓解11例(33.3%),部分缓解21例(63.6%),所有患者KPS评分均有上升。平均生存期17.4个月,未出现严重不良反应。结论伽玛刀治疗脑转移瘤具有疗效好、安全的优势,能有效提高脑转移瘤患者生活质量,延长生存期。
Objective To investigate the recent clinical efficacy and adverse reactions of gamma knife in the treatment of brain metastases. Methods Forty-eight patients (108 lesions) with brain metastases were treated with Gamma Knife. The peripheral tumor dose was 14-21 Gy with an average of 18 Gy. The maximum dose in the center was 32-40 Gy with an average of 35.4 Gy. Results The follow-up of 48 patients with gamma knife was followed up for 1 to 27 months with an average of 10 months, with complete remission in 8 cases (16.7%), partial remission in 26 cases (54.2%) and no change in 10 cases (20.8%), progression in 4 cases (8.3%), and local tumor control rate was 91.7% (44/48). In 33 patients with neurological symptoms, neurological symptoms were completely relieved in 11 (33.3%), partial response in 21 (63.6%), and KPS in all patients. The average survival period of 17.4 months, no serious adverse reactions. Conclusion Gamma knife treatment of brain metastases with good efficacy and safety advantages, can effectively improve the quality of life of patients with brain metastases, prolong survival.