CAJ | 학술논문

目的总结姑息性伽玛刀治疗老年(≥65岁)脑转移瘤患者的治疗效果. 方法福建医科大学附属协和医院伽玛刀治疗中心自2004年3月至2010年3月共治疗134例老年脑转移瘤患者,共治疗212次,治疗病灶403个,平均中心剂量及边缘剂量分别为(29.3±8.4) Gy和(15.9±4.8) Gy.Kaplan-Meier方法计算患者的中位生存期,Cox回归分析影响伽玛刀治疗效果的临床因素. 结果获影像学随访的372个病灶中,完全消失66个(17.7％),部分缓解174个(46.8％),无变化94个(25.3％),部分进展38个(10.2％).Kaplan-Meier分析显示患者中位生存期为10.9个月.影响伽玛刀治疗效果的因素为治疗前KPS评分、脑转移预后分级(RPA分级)、转移瘤数目和原发肿瘤的控制情况. 结论伽玛刀治疗老年脑转移瘤是安全有效的姑息性治疗手段,有助于维持患者良好的生活质量.
목적 총결고식성가마도치료노년(≥65세)뇌전이류환자적치료효과. 방법 복건의과대학부속협화의원가마도치료중심자2004년3월지2010년3월공치료134례노년뇌전이류환자,공치료212차,치료병조403개,평균중심제량급변연제량분별위(29.3±8.4) Gy화(15.9±4.8) Gy.Kaplan-Meier방법계산환자적중위생존기,Cox회귀분석영향가마도치료효과적림상인소. 결과 획영상학수방적372개병조중,완전소실66개(17.7％),부분완해174개(46.8％),무변화94개(25.3％),부분진전38개(10.2％).Kaplan-Meier분석현시환자중위생존기위10.9개월.영향가마도치료효과적인소위치료전KPS평분、뇌전이예후분급(RPA분급)、전이류수목화원발종류적공제정황. 결론 가마도치료노년뇌전이류시안전유효적고식성치료수단,유조우유지환자량호적생활질량.
Objective To evaluate the therapeutic effect of Gamma knife radiosurgery (GKRS) on patients aged ≥65 years who presented with brain metastasis. Methods The clinical treatment and follow-up data of 134 patients,admitted to and treated with GKRS in our hospital from March 2004 to March 2010,were analyzed.These 134 patients totally underwent 212 GKRS for 403 metastases.The median maximal and marginal doses were (29.3±8.4) Gy and (15.9±4.8) Gy,respectively.Kaplan-Meier survivor analysis was utilized to calculate the median survive time and multivariate analysis was employed to determine the clinical factors influencing the treatment outcome. Results Of the 372 metastasis followed by imaging,complete response was achieved in 66 lesions (17.7％),partial response in 174 lesions (46.8％),no change in 94 lesions (25.3％),and partial progression in 38 lesions (10.2％).Median survival was 10.9 months.Grade of recursive partitioning analysis (RPA),number of tumors,scores of Karnofsky performance scale (KPS) and status of primary malignancies were found to be factors influencing the efficacy (P＜0.05). Conclusion GKRS for patients aged over 65 years with brain metastases is an effective and safe treatment method that appears to improve survival and is helpful in maintaining relative good life quality in selected population