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目的 对比分析X线立体定向分次放射治疗 (fractionatedstereotacticradiotherapy ,FSRT)加全脑放疗与单纯FSRT和单纯全脑放疗对颅内脑转移瘤的疗效及影响。方法 颅内脑转移瘤患者 15 4例 ,中位年龄 5 8 4岁 ,病灶数 316个 ,平均体积 16 5 3mm3 ,6 2例行FSRT加全脑放疗 ,单纯FSRT 32例 ,单纯全脑放疗 6 0例。FSRT等中心剂量 16～ 2 4Gy/1周 ,全脑放疗 30～ 4 0Gy/3～ 4周。单纯全脑放疗 30～ 4 0Gy/3～ 4周后缩野加量 10～ 18Gy/1～ 2周。结果 FSRT加全脑放疗中位生存期 11个月 ,完全缓解 (CR) +部分缓解 (PR) 97 9%。 1年生存率 4 5 % ,2年生存率为 13 3% ,局部复发率 5 %。单纯FSRT ,中位生存期 8个月 ,CR +PR 10 0 % ;1年生存率 2 9% ,2年生存率 9 7% ,局部复发率 6 4 %。全脑放疗中位生存时间 4 5个月 ,CR +PR 6 2 4 % ,1年生存率 8 92 % ,局部复发率 10 7%。FS RT加全脑放疗和FSRT分别与全脑放疗方法疗效比较 ,经统计学处理几项指标差异均有显著性。局控率分别为χ21,3 =32 5 ,P <0 0 0 1,χ22 ,3 =12 13,P <0 0 0 1;1年生存率分别为 χ21,3 =18 87,P <0 0 0 1,χ22 ,3 =5 97,P <0 0 5 ;KPS评分比较分别为 χ2 =8 87,P <0 0 1,χ2 =7 18,P <0 0 1;实体瘤客观疗效评价分别为 χ2 =2
Objective To compare and analyze the efficacy and impact of X-ray fractionated stereotacticradiotherapy (FSRT) combined with whole-brain radiotherapy and FSRT alone and whole-brain radiotherapy on intracranial brain metastases. Methods 15 4 patients with intracranial brain metastases had a median age of 584 years and 316 lesions with an average volume of 16 53 mm3. Sixty patients underwent FSRT plus whole-brain radiotherapy. Only FSRT was given in 32 cases and pure whole-brain radiotherapy 6 0 cases. FSRT center dose of 16 ~ 2 4Gy / 1 week, whole brain radiation 30 ~ 40Gy / 3 ~ 4 weeks. Simple whole brain radiotherapy 30 ~ 40Gy / 3 ~ 4 weeks after the wild plus 10 ~ 18Gy / 1 ~ 2 weeks. Results The median survival of FSRT plus whole brain radiotherapy was 11 months, with complete remission (CR) + partial remission (PR) 97.9%. The 1-year survival rate was 45%, the 2-year survival rate was 13 3% and the local recurrence rate was 5%. In simple FSRT, the median survival time was 8 months, CR + PR 10%; 1-year survival rate was 29%, 2-year survival rate was 9 7%, and local recurrence rate was 64%. The median survival time of whole-brain radiotherapy was 45 months. CR + PR 6 24%, 1-year survival rate 8 92%, and local recurrence rate 10 7%. FS RT plus whole brain radiotherapy and FSRT were compared with the whole brain radiotherapy method efficacy, the statistical analysis of several indicators were significant differences. The local control rates were χ21,3 = 32 5, P <0 01, χ22, 3 = 12 13, P 0 01; the 1-year survival rates were χ21,3 = 18 87, P 0 00 0 1, χ22, 3 = 5 97, P 0 05; KPS scores were χ2 = 8 87, P 0 01, χ 2 = 7 18, P 0 01, respectively. The objective evaluation of solid tumors were χ2 = 2