临床神经外科杂志2023，Vol.20Issue(6)：671-676,6.DOI:10.3969/j.issn.1672-7770.2023.06.013
脑转移瘤的放射外科治疗的新模式:2阶段伽玛刀放射外科治疗策略探索及疗效分析
A novel radiosurgery for brain metastases:strategy and efficacy of two-staged gamma knife radiosurgery
摘要
Abstract
Objective To evaluate the utility of two-staged gamma knife radiosurgery in patients with large,high-risk brain metastases.Method A total of 53 large or high-risk brain metastases in 39 patients treated with two-staged gamma knife radiosurgery at Shanghai Gamma Hospital from December 1,2017 to June 30,2020 were analyzed retrospectively.The initial tumor volume was(15.4±11.5)cm3.The two-staged gamma knife radiosurgery plan with a long interval(13.1±9.3 days)were designed for patients.Volumetric measurements at the first stage,second stage,and follow-up imaging studies were obtained to analyze the local control effect of this strategy.In addition,the improvement of Karnofsky performance scale(KPS),overall survival of the patients,and the occurrence of radiation toxicities were observed respectively.Results 100％of patients successfully tolerated the two-staged gamma knife radiosurgery.At the second stage of treatment,all tumor volumes decreased by an average of 24.8％±21.1％.After the second stage of treatment,the tumor volumes decreased by an average of 68.3％±20.4％,74.6％±22.2％,70.4±23.7％,and 66.9±34.4％ at 3,6,9,and 12 months,respectively.The 12 month and 24 month survival rates were 80％ and 60％,respectively.The median overall survival time was 24 months.11.3％ of the lesions experienced recurrence,with a median recurrence time of 21.5(9-24)months.15.1％ of patients experienced radiation reactions with a median time of 9 months(6-10 months).Conclusion Staged radiosurgery can be an efficient and safe alternative treatment for large or high risk brain metastases.关键词
分阶段放射外科/脑转移瘤/伽玛刀/2阶段Key words
staged radiosurgery/brain metastases/gamma knife/two-staged分类
医药卫生引用本文复制引用
丁建波,涂兰芳,陈晶晶,王恩敏,许云,潘力,王滨江,张南,吴瀚峰,汤旭群,于同刚..脑转移瘤的放射外科治疗的新模式:2阶段伽玛刀放射外科治疗策略探索及疗效分析[J].临床神经外科杂志,2023,20(6):671-676,6.基金项目
上海市卫生健康委员会科研课题基金资助项目(20194Y0482) （20194Y0482）
