Jokura H, Takahashi K, Kayama T, Yoshimoto T
Jiro Suzuki Memorial Clinic, Furukawa, Japan.
Acta Neurochir Suppl. 1994;62:77-82. doi: 10.1007/978-3-7091-9371-6_16.
From December 1991 to October 1992, 77 lesions in 25 consecutive patients were treated with Gamma Knife radiosurgery. Thirteen patients (52%) had multiple metastases up to sixteen lesions and twelve patients had a single metastasis. The volume of the largest tumour treated was 12.5 cm3. Karnofsky performance status (KPS) of the patients was 20-90% (mean 70). Marginal tumour dose given was 18 to 35 Gy (mean 26.1 Gy) in 30 to 90% isodose line according to the tumour volume and site. All but two patients were followed by MRI or CT scan repeatedly for a minimum of 6 month or to death. All but one of the tumours were locally controlled. Seventeen patients died during follow up and in four death was due to remote CNS metastases. The median survival for this minimally selected group of patients was 8.5 months, and the median survival for the patients with a single metastasis was 10.5 months. In patients with multiple metastases the median survival reached only 2.5 months but in 11 patients out of 13 patients neurological symptoms and signs improved or stabilized shortly after radiosurgery.
1991年12月至1992年10月，连续25例患者的77个病灶接受了伽玛刀放射外科治疗。13例患者（52%）有多达16个病灶的多发转移，12例患者有单发转移。接受治疗的最大肿瘤体积为12.5立方厘米。患者的卡氏功能状态评分（KPS）为20%-90%（平均70）。根据肿瘤体积和部位，在30%-90%等剂量线给予的边缘肿瘤剂量为18至35 Gy（平均26.1 Gy）。除2例患者外，所有患者均接受了至少6个月的反复MRI或CT扫描或直至死亡。除1个肿瘤外，所有肿瘤均实现局部控制。17例患者在随访期间死亡，4例死于远处中枢神经系统转移。这组经过最低限度选择的患者的中位生存期为8.5个月，单发转移患者的中位生存期为10.5个月。多发转移患者的中位生存期仅为2.5个月，但13例患者中有11例在放射外科治疗后不久神经症状和体征有所改善或稳定。
