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目的:探讨X线立体定向放射治疗脑转移瘤的临床价值。方法:采用X线立体定向技术,单次、大剂量照射脑转移瘤,设4个~9个非共面照射野,80%等中心剂量线覆盖PTV。多发转移灶,根据肿瘤所在位置、大小及局部周边水肿情况和全身状况配合全脑照射。结果:424例患者均顺利完成治疗全程,成功率100%。加速器等中心精确度(0.5±0.2)mm,无严重副反应。6个月、12个月、24个月生存率分别为87%、75%和15%,中位生存10.7个月。结论:X线立体定向放射治疗技术治疗脑转移瘤精度高、近期改善局部症状快、损伤小且安全,尤其对单发的小病灶(≤3cm)具有较高的临床价值。
Objective: To investigate the clinical value of X-ray stereotactic radiotherapy for brain metastases. Methods: X - ray stereotactic technique was used to irradiate brain metastases with single and high dose. Four to nine non - coplanar irradiation fields and 80% isodose coverage lines were used to cover PTV. Multiple metastases, according to the location of the tumor, size and local peripheral edema and systemic conditions with the whole brain irradiation. Results: All 424 patients completed the treatment successfully, with a success rate of 100%. Accelerator center accuracy (0.5 ± 0.2) mm, no serious side effects. The survival rates at 6 months, 12 months and 24 months were 87%, 75% and 15%, respectively. The median survival time was 10.7 months. Conclusion: X-ray stereotactic radiotherapy has the advantages of high precision in the treatment of brain metastases, recent improvement of local symptoms, small injury and safety, especially for single lesion (≤3cm), which has high clinical value.