CAJ | 학술논문

目的对伽玛刀放射外科(GKRS)治疗脑干转移的疗效及安全性进行评价.方法 30例GKRS治疗的脑干转移瘤患者进行随访分析.其中男20例,女10例,平均年龄62.4岁(范围:37～71岁).转移病灶位于桥脑19例,中脑7例,延髓4例.原发肿瘤为肺癌22例,乳腺癌3例,结肠癌2例,肾癌2例,卵巢癌1例.肿瘤平均体积1 cm3(范围:0.008～ 3.5 cm3),全部病例采用剂量分割治疗方法,分2次照射,每次6 ～8 Gy,间隔8h,平均处方剂量为14 Gy(范围:12 ～ 16 Gy).GKRS治疗后3个月进行磁共振成像(MRI)复查,平均随访时间18个月(范围:15～48个月).对影响预后的相关因素进行分析.结果复查MRI显示肿瘤完全缓解7例,肿瘤部分缓解15例,肿瘤无变化4例,肿瘤进展4例,肿瘤局部控制率86.7％.平均生存期11.8个月(范围:3～48个月).相关因素分析KPS评分超过70分和肿瘤体积小于1 cm3是良好的预后因素(P＜0.05).结论 GKRS是脑干转移瘤安全有效的治疗方法,患者的全身状态和肿瘤大小是影响生存期的重要因素.
목적 대가마도방사외과(GKRS)치료뇌간전이적료효급안전성진행평개.방법 30례GKRS치료적뇌간전이류환자진행수방분석.기중남20례,녀10례,평균년령62.4세(범위:37～71세).전이병조위우교뇌19례,중뇌7례,연수4례.원발종류위폐암22례,유선암3례,결장암2례,신암2례,란소암1례.종류평균체적1 cm3(범위:0.008～ 3.5 cm3),전부병례채용제량분할치료방법,분2차조사,매차6 ～8 Gy,간격8h,평균처방제량위14 Gy(범위:12 ～ 16 Gy).GKRS치료후3개월진행자공진성상(MRI)복사,평균수방시간18개월(범위:15～48개월).대영향예후적상관인소진행분석.결과 복사MRI현시종류완전완해7례,종류부분완해15례,종류무변화4례,종류진전4례,종류국부공제솔86.7％.평균생존기11.8개월(범위:3～48개월).상관인소분석KPS평분초과70분화종류체적소우1 cm3시량호적예후인소(P＜0.05).결론 GKRS시뇌간전이류안전유효적치료방법,환자적전신상태화종류대소시영향생존기적중요인소.
Objective To evaluate the efficacy and safety of brainstem metastasis treated with gamma knife radiosurgery (GKRS).Methods A total of 30 patients with brainstem metastasis (10 women and 20 men) treated with GKRS in our center were followed up and analyzed.Their mean age was 62.4 years (range,37-71).The metastatic lesions of 19 patients were in the pons,7 were in the midbrain,4 were in the medulla oblongata.The primary tumor was lung cancer in 22 cases,breast cancer in 3 cases,colon cancer in 2 cases,kidney cancer in 2 cases,and ovarian cancer in 1 case.The mean tumor volume was 1 cm3 (range,0.008-3.5 cm3).All patients were treated by using the dose division method.They were irradiated for twice,each time 6-8 Gy,interval 8 h.The mean prescription dose was 14 Gy (range,12-16).Magnetic resonance imaging (MRI) was performed at 3 months after GKRS treatment.The mean follow-up time was 18 (range,15-48) months.The related factors affecting prognosis were analyzed.Results The follow-up MRI revealed that the tumors disappeared completely in 7 cases,disappeared partially in 15 cases,the tumors did not have any change in 4 cases,and the tumor progression was in 4 cases.The local tumor control rate was 86.7％.The mean survival period was 11.8 (range,3-48) months.The correlation factor analysis showed that the KPS score more than 70 and the tumor volume less than 1 cm3 were the good prognostic factors (P ＜ 0.05).Conclusions GKRS is a safe and effective treatment method for brainstem metastasis.The general condition of patients and the tumor size are the important factors for affecting survival period.