摘要
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。
OBJECTIVE： To evaluate the efficacy of conformal re- diotherapy 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 Dr 54 60 Gy/ （27--30） fractions by three dimentional conformal radiotherapy （3D-CRT） after whole brain radiotherapy to DT 40 Gy/20 fractions. The patients with single brain metastases were directly received 3D CRT to DT 54--60 Gy/（27--30） fractions. Thirty-four patients re- ceived chemoradiotherapy. Multivariate analysis was performed by the Cox regression proportional hazard model. RESULTS： For all the 40 patients, the clinical symptom remission rate was 92.5% （37/40）. The whole response rate （RR） and clinical benefit rate （CBR） was 62.5% （25/40） and 97.5 % （39/40） respectively. The median intracranial con trol time was 7.2 months,while 6 months and 1 year intracranial control rate was 47. 5% and 10. 0% respectively. The median survival time was 10.5 months,while 6 months,1 year and 2 year survival rate was 65.0% ,25.0% and 5.0% respectively. The patients with comprehensive ehemoradiotherapy tended to live longer than the ones with radiotherapy alone, but the statistic difference was not detected （P = 0. 290）. Cox multivariate analysis showed that the independent prog nostic factors for patients with brain metastases treated by 3D-CRT were KPS performance status, extracranial primary tumor status（P〈0. 05）. CONCLUSIONS： The eonformal radiotherapy for patients with brain metastases can obviously release the clinical symptom, improve quality of life,and significantly increase the survival time. Performance status, extracranial primary tumor status are independent prognostic factors.
出处
《中华肿瘤防治杂志》
CAS
2011年第21期1696-1699,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
脑肿瘤
肿瘤转移
放射疗法
适形
预后
因素分析
统计学
brain neoplasms
neoplasms metastases
radiotherapy, conformal ~ prognosis
factor analysis, statistical
