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目的 探讨安全有效、适应证广、并能提高生存质量和延长生存期的脑转移瘤治疗方法。方法 采用伽玛刀治疗脑转移瘤 44 0例 ,共 975个病灶。获得随访 42 0例 ,共 815个病灶 (生存半年以上者 )。结果 2年至今仍存活患者 49例 (10 .0 % ) ,其中存活 3年以上的 2 7例 ,4年以上的 16例 ,5年以上的 6例。 2年以上存活的 49例患者中 ,单发病灶者 42例 ,2～ 3个病灶者 7例 ,超过 3个病灶者没有一个患者超过 2年生存期。 42 0例早期随访病例中 ,72例患者在1个月内神经系统症状及体征明显缓解和改善 (19% ) ,2～ 3个月则达到 3 85例 (87% ) ,3 0例无变化 (8.7% ) ,2 5例加重(5 .3 % )。术后平均生存期 13 .6个月 ,最长达 5年 2个月。结论 伽玛刀作为一种微侵袭神经外科技术治疗脑转移瘤 ,具有侵袭少、无痛苦、恢复快、住院时间短、安全可靠、致残率低的特点 ,且对全身情况要求低 ,更适合于脑内多发的、深部的肿瘤治疗
Objective To investigate the treatment of brain metastases which is safe and effective, has a wide range of indications, and can improve the quality of life and extend the survival period. Methods Gamma knife treatment 440 cases of brain metastases, a total of 975 lesions. 42 follow-up cases were obtained, a total of 815 lesions (survival of more than six months). Results 49 patients (10.0%) survived in two years, of which 27 cases survived for more than 3 years, 16 cases more than 4 years and 6 cases more than 5 years. Of the 49 patients who survived more than 2 years, 42 had single lesions, 7 had 2 or 3 lesions, and none of more than 3 had more than 2 years of survival. Of the 42 early-follow-up cases, 72 (72%) significantly reduced and improved neurological symptoms and signs in 1 month (85%, 87%) in 2 to 3 months and no change in 30 patients (8.7%), 25 cases of aggravating (5.3%). The average postoperative survival time of 13.6 months, up to 5 years and 2 months. Conclusions Gamma knife is a kind of minimally invasive neurosurgery for the treatment of brain metastases. It has the characteristics of less invasion, no pain, fast recovery, short hospital stay, safe and reliable, low morbidity and low requirement for general condition In the brain multiple, deep tumor treatment