目的 评价伽玛刀立体定向放射外科治疗放射抗拒性肿瘤脑转移病灶的疗效.方法 回顾分析31例放射抗拒性肿瘤脑转移患者的临床资料,对数据进行多变量Cox回归分析,研究生存时间与其他变量之间的关系.结果 伽玛刀立体定向放射外科治疗后平均生存时间为12个月(95%CI,7～17个月),中位生存时间为7个月.1年及2年生存率分别为32.3%(10/31)及12.9%(4/31).总生存时间与肿瘤控制时间呈正相关(P<0.01),与转移灶数量呈负相关(P<0.05).脑转移灶疾病进展时间与肿瘤体积呈负相关(P<0.05),而前期全脑放疗及治疗剂量与生存无相关性(P>0.05).结论 伽玛刀立体定向放射外科治疗放射抗拒性肿瘤脑转移患者可以更好地控制脑转移病灶并延长生存时间,是一种安全且有效的方法.%Objective To evaluate the effects of Gamma knife stereotactic radiosurgery on brain metastases from radioresistant primary cancer. Methods Retrospectively reviewed the clinical data of 31 patients with brain metastases from radioresistant primary cancer. All data were coded and entered into multivariate Cox regression analysis for investigating the relationship between survival time and other variables. Results Mean survival time from radiosurgery was 12 months ( 95％ CI, 7 ～ 17 months ) and the median survival time was 7 months. The 1 year and 2 years survival rates were 32.3％( 10/31 ) and 12.9％ ( 4/31 ) respectively. The overall survival time was positively related to tumor control time( P ＜ 0.01 ) and negatively to the number of metastases( P ＜ 0.05 ). Brain metastases progress time was negatively related to tumor size( P ＜ 0.05 ). The prior whole brain radiotherapy and increased raiosurgery dose did not affect survival( P ＞ 0.05 ). Conclusion Gamma knife stereotactic radiosurgery for intracranial metastases from conventionally radioresistant primary cancers is a safe and effective method to provide better local control of the brain disease and improve survival time.
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