Baumert B, Steinauer K, Lütolf U M
Klinik und Poliklinik für Radio-Onkologie, Universitätsspital Zürich.
Ther Umsch. 1999 Jun;56(6):338-41. doi: 10.1024/0040-5930.56.6.338.
Brain metastases occur in 20-30% of patients with systemic cancer and represent one of the most unfavourable prognostic parameters. In the majority of cases brain metastases are multiple and are usually treated with whole brain irradiation. The treatment of single brain metastases often includes surgery, followed by whole brain radiotherapy. Although the goal of treatment of both single and brain metastases is almost always palliation and not cure, it is important that several modes of treatment are carefully compared. In comparing different treatment regimens it should be emphasised that not only duration of survival time and time until tumour recurrence are used as outcome parameters but also the quality of life. The only way in which the results of different therapies can be compared is by means of randomised trials. As long as high quality studies are not available, any definitive assessment of the relative effectiveness of radiosurgery to standard treatment for brain cannot be defined. Radiosurgery can be used to treat patients, whose metastases recur after traditional therapies. As with other definitive therapies for patients with brain metastases, highly functional patients with well-controlled systemic cancers derive the greatest benefit from treatment with radiosurgery.
脑转移瘤发生于20% - 30%的全身癌症患者中，是最不利的预后参数之一。在大多数情况下，脑转移瘤是多发的，通常采用全脑照射治疗。单个脑转移瘤的治疗通常包括手术，随后进行全脑放疗。尽管单发和多发脑转移瘤的治疗目标几乎总是姑息治疗而非治愈，但仔细比较几种治疗方式很重要。在比较不同治疗方案时，应强调不仅将生存时间和肿瘤复发时间作为疗效参数，还应考虑生活质量。比较不同疗法结果的唯一方法是通过随机试验。只要没有高质量的研究，就无法对放射外科治疗与脑标准治疗的相对有效性进行任何明确评估。放射外科可用于治疗传统疗法后转移瘤复发的患者。与其他针对脑转移瘤患者的确定性疗法一样，全身癌症得到良好控制的高功能患者从放射外科治疗中获益最大。
