Grob J J, Regis J, Laurans R, Delaunay M, Wolkenstein P, Paul K, Souteyrand P, Koeppel M C, Murraciole X, Perragut J C, Bonerandi J J
Dermatology Department, Hôpital Sainte-Marguerite, Marseille, France.
Eur J Cancer. 1998 Jul;34(8):1187-92. doi: 10.1016/s0959-8049(98)00026-4.
To evaluate the effectiveness of radiosurgery without whole brain radiotherapy in the palliative treatment of melanoma brain metastases, we retrospectively assessed the results in 35 patients: 4 with a solitary brain metastasis, 13 with a single brain metastasis and metastases elsewhere and 18 with multiple brain metastases. The local control rate was 98.2% (55/56 metastases) at 3 months. Median survival was 22 months in patients with a solitary brain metastasis, 7.5 months in patients with a single brain metastasis and metastases elsewhere, and 4 months in patients with multiple brain metastases. Complications were unusual and surgery was required in 2 of 35 patients. These results show for the first time that melanoma patients with a unique brain metastasis with or without metastases elsewhere clearly benefit from tumour control easily obtained by radiosurgery. Although the comparison of radiosurgery with surgery and/or whole brain radiotherapy cannot be adequately addressed, radiosurgery alone seems to provide similar results with lower morbidity and impact on quality of life.
为评估在黑色素瘤脑转移瘤姑息治疗中不进行全脑放疗的放射外科手术的有效性，我们回顾性评估了35例患者的结果：4例为孤立性脑转移瘤，13例为单一脑转移瘤且伴有其他部位转移，18例为多发脑转移瘤。3个月时局部控制率为98.2%（56个转移瘤中的55个）。孤立性脑转移瘤患者的中位生存期为22个月，单一脑转移瘤且伴有其他部位转移的患者为7.5个月，多发脑转移瘤患者为4个月。并发症不常见，35例患者中有2例需要手术治疗。这些结果首次表明，有或没有其他部位转移的孤立性脑转移瘤的黑色素瘤患者明显受益于通过放射外科手术轻松实现的肿瘤控制。虽然无法充分探讨放射外科手术与手术和/或全脑放疗的比较，但单独的放射外科手术似乎能提供相似的结果，且发病率更低，对生活质量的影响更小。
