伽玛刀治疗脑转移瘤近期疗效影响因素分析

发布时间：2018-03-20 22:11

本文选题：脑转移瘤　切入点：伽玛刀　出处：《山东大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究背景脑转移瘤是原发于机体其他部位的恶性肿瘤通过血运等途径侵犯入脑所形成的颅内占位性病变,是中枢神经系统最常见的肿瘤之一,约占所有颅内肿瘤的10%左右。近年来随影像学技术进步带来的检出率提高,恶性肿瘤治疗技术发展、患者生存期延长,脑转移瘤的发病呈增加趋势。脑转移瘤大多恶性程度高,一旦确诊意味着疾病终末期,预后不良。既往治疗方式以手术、放射治疗等为主,能够一定程度上改善患者预后,但同时因为其适应症有限及并发症等原因限制其应用。以伽玛刀为代表的立体定向放射外科(stereotactic radiosurgery,SRS)技术的逐渐发展为脑转移瘤治疗提供了新的治疗手段。伽玛刀能够提高局部肿瘤组织的放射剂量,对周围正常脑组织损伤小,有效率高,副反应少,近年来得到广泛运用。山东大学第二医院于瑞典医科达公司引进第六代伽玛刀(Leksell Gamma Knife Perfexion,PFX伽玛刀),自2016年5月至2017年2月,共应用伽玛刀治疗脑转移瘤50例,效果良好。本研究收集上述患者的临床资料,评估近期疗效,并对相关影响因素做初步探讨。研究目的探讨伽玛刀治疗脑转移瘤的近期临床疗效及其相关影响因素。研究方法回顾性分析自2016年5月至2017年2月收治的脑转移瘤行伽玛刀治疗的患者50例,分类汇总年龄、性别、治疗前KPS评分、治疗前GPA评分、颅内转移瘤是否累及重要部位、是否合并其他颅外转移、原发灶与脑转移瘤是否同时发现等临床资料并列为影响因素。术后3月随访评价近期疗效,以卡方检验分析各个影响因素与近期疗效关系。研究结果脑转移瘤完全缓解15例(30%),部分缓解11例(22%),无变化16例(32%),进展8例(16%),判定26例患者(52%)疗效良好,24例患者(48%)判为疗效不良。卡方检验示脑转移瘤近期疗效与治疗前KPS评分、治疗前GPA评分、是否累及重要部位、原发灶与脑转移瘤是否同期发现有关,与年龄、性别及是否存在其他颅外转移无关。术后无严重不良反应。结论:1.伽玛刀治疗脑转移瘤有效率高、近期疗效满意,并发症少;2.伽玛刀治疗脑转移瘤近期疗效与治疗前KPS评分、治疗前GPA评分、是否累及重要部位、原发灶与脑转移瘤是否同期发现有关。
[Abstract]:Background brain metastasis is one of the most common tumors in the central nervous system. It accounts for about 10% of all intracranial tumors. In recent years, with the development of imaging technology, the detection rate of brain metastases has increased, the treatment of malignant tumors has developed, the survival time of patients has been prolonged, and the incidence of brain metastases is increasing. Once the diagnosis indicates the end stage of the disease, the prognosis is not good. The previous treatment methods, such as surgery and radiotherapy, can improve the prognosis of the patients to a certain extent. But at the same time, the application of stereotactic radiosurgery SRS, represented by gamma knife, was limited because of its limited indications and complications. The development of stereotactic radiosurgeryn SRS (stereotactic radiosurgery SRS) technique provides a new method for the treatment of brain metastases. Gamma knife can be used to treat brain metastases. Enough to increase the radiation dose of local tumor tissue, In recent years, the second Hospital of Shandong University introduced 6th generation Leksell Gamma Knife Perfexion PFX Gamma knife from Swedish Medical Corporation, from May 2016 to February 2017. A total of 50 cases of brain metastases were treated with gamma knife. The clinical effect of gamma knife in the treatment of brain metastases and its related influencing factors were discussed. Methods from May 2016 to February 2017, the clinical effects of brain metastases were analyzed retrospectively. There were 50 patients with tumor treated with gamma knife. Age, sex, KPS score before treatment, GPA score before treatment, whether intracranial metastases involved important sites, and whether other extracranial metastases were involved, Whether the primary tumor and the brain metastases were found at the same time were the influencing factors. Results there were 15 cases of complete remission of brain metastases, 30 cases of partial remission, 16 cases of no change, 8 cases of progression and 8 cases of progress. Chi-square test showed that the short-term curative effect of brain metastases and the KPS score before treatment. Before treatment, GPA score, whether the important site was involved, whether the primary tumor and brain metastases were found at the same time, and whether it was related to age, There was no serious adverse reaction after operation. Conclusion: Gamma knife has high effective rate, satisfactory short-term curative effect and few complications in treating brain metastases. [WT5HZ] the short-term curative effect of gamma knife on brain metastases and the KPS score before treatment were significant. Before treatment, GPA score, whether the important site involved, and whether the primary tumor and brain metastases were found at the same time.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R730.55;R739.41

【相似文献】