Department of Neurological Surgery, University of Pittsburgh, UPMC Presbyterian, Pittsburgh, Pennsylvania 15213, USA.
Int J Radiat Oncol Biol Phys. 2010 Aug 1;77(5):1457-62. doi: 10.1016/j.ijrobp.2009.07.012. Epub 2010 Jan 7.
We evaluated the role of Gamma Knife stereotactic radiosurgery in the multidisciplinary management of brain metastases from an undiagnosed primary cancer.
Twenty-nine patients who had solitary or multiple brain metastases without a detectable primary site underwent stereotactic radiosurgery between January 1990 and March 2007 at the University of Pittsburgh. The median patient age was 61.7 years (range, 37.9-78.7 years). The median target volume was 1.0 cc (range, 0.02-23.6 cc), and the median margin radiosurgical dose was 16 Gy (range, 20-70 Gy).
After radiosurgery, the local tumor control rate was 88.5%. Twenty four patients died and 5 patients were living at the time of this analysis. The overall median survival was 12 months. Actuarial survival rates from stereotactic radiosurgery at 1 and 2 years were 57.2% and 36.8%, respectively. Factors associated with poor progression-free survival included large tumor volume (3 cc or more) and brainstem tumor location.
Radiosurgery is an effective and safe minimally invasive option for patients with brain metastases from an unknown primary site.
我们评估了伽玛刀立体定向放射外科在不明原发灶脑转移瘤多学科综合治疗中的作用。
1990 年 1 月至 2007 年 3 月，匹兹堡大学对 29 例无明确原发病灶的单发或多发脑转移患者进行了立体定向放射外科治疗。患者中位年龄 61.7 岁（范围 37.9-78.7 岁）。中位靶体积为 1.0 cc（范围 0.02-23.6 cc），中位边缘放射外科剂量为 16 Gy（范围 20-70 Gy）。
放射外科治疗后局部肿瘤控制率为 88.5%。24 例患者死亡，5 例患者在分析时仍存活。总体中位生存时间为 12 个月。立体定向放射外科治疗 1 年和 2 年的生存率分别为 57.2%和 36.8%。无进展生存不良的相关因素包括肿瘤体积大（3 cc 或以上）和脑干肿瘤位置。
放射外科治疗是不明原发灶脑转移瘤患者一种有效且安全的微创选择。
