脑部转移瘤采用 Cyberknife 治疗。

Brain metastasis treated with Cyberknife.

机构信息

Key Laboratory of Cancer Prevention and Therapy and Department of Radiation Therapy, Tianjin Cancer Hospital of Tianjin Medical University, Tianjin, China.

出版信息

Chin Med J (Engl). 2009 Aug 20;122(16):1847-50.

PMID:19781358

Abstract

BACKGROUND

Cyberknife can greatly raise the fractional dose of stereotactic radiosurgery, thus improving its clinical efficacy. We retrospectively analyzed clinical outcomes of brain metastasis treated with Cyberknife.

METHODS

We analyzed 40 cases of brain metastases treated with Cyberknife in the Tianjin Cancer Hospital from August 1, 2006 to August 1, 2007, for a total of 68 lesions with maximal diameter of 0.4 - 7.5 cm (average 1.88 cm). Total hypofractional radiated dosage was 18 - 36 Gy (5 - 25 Gy/F, 1 - 5 F) by Cyberknife. We evaluated the remission rate of clinical symptoms, correlation factors to new foci, 3-month local control rates, and 3-month and 1-year survival rates. All patients were followed up for more than 14 months.

RESULTS

After 1 week, clinical remission was 90.0% (36/40). After 3 months, the local control rate and therapeutic effective rate were 77.9% (53/68) and 94.1% (64/68), respectively, as observed by cranium augmentation CT or MRI. The three-month, six-month and 1-year survival rates were 97.5% (39/40), 82.5% (33/40) and 67.5% (27/40), respectively. Fourteen patients had neopathy outside the original lesion after 3 months. Neopathy was not correlated with age, whole-brain radiotherapy, number of original lesions, maximum diameter of the original lesion, therapeutic dose per fraction, therapeutic frequency or total therapeutic dose.

CONCLUSIONS

Cyberknife got perfect clinical outcomes by higher dosage per fraction. It is an appropriate and valid treatment shortcut for brain metastasis.

摘要

背景

Cyberknife 能够显著提高立体定向放射外科的分次剂量，从而提高其临床疗效。我们回顾性分析了 Cyberknife 治疗脑转移瘤的临床结果。

方法

我们分析了 2006 年 8 月 1 日至 2007 年 8 月 1 日在天津市肿瘤医院接受 Cyberknife 治疗的 40 例脑转移瘤患者，共 68 个病灶，最大直径 0.4-7.5cm（平均 1.88cm）。Cyberknife 总分割剂量为 18-36Gy（5-25Gy/F，1-5F）。我们评估了临床症状缓解率、新发病灶的相关因素、3 个月局部控制率、3 个月和 1 年生存率。所有患者随访时间均超过 14 个月。

结果

治疗后 1 周，临床缓解率为 90.0%（36/40）。治疗后 3 个月，头颅增强 CT 或 MRI 观察到局部控制率和治疗有效率分别为 77.9%（53/68）和 94.1%（64/68）。3 个月、6 个月和 1 年的生存率分别为 97.5%（39/40）、82.5%（33/40）和 67.5%（27/40）。14 例患者在 3 个月后出现原病灶以外的新发病灶。新发病灶与年龄、全脑放疗、原发病灶数量、原病灶最大直径、治疗剂量分割、治疗频率或总治疗剂量无关。