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目的探讨Ｘ线立体定向放射治疗在脑转移瘤常规放射治疗中的作用。材料与方法在４种预后因素（年龄、疗前ＫＰＳ评分、有无远处转移及是否单发转移灶）相同或相似的条件下，配对选择两组病例，Ｘ线立体定向放射治疗加常规放疗组４０例，常规放疗组８０例，常规放疗组采用全脑照射３０～４０Ｇｙ／３～４周；在Ｘ线立体定向放射治疗加常规放疗组中，Ｘ线立体定向放射治疗采用单次照射２７例，分次照射１３例，单次靶区平均处方剂量为１３．４Ｇｙ，分次照射方法为５～１０Ｇｙ／次，每周２次，总量达１５～３０Ｇｙ。结果Ｘ线立体定向放射治疗加常规放疗组与单纯常规放疗组比较：１年生存率分别为５０％，２０％；１年局控率分别为７３％，１５％；治疗后ＫＰＳ评分好转的比例分别为８８％，５６％；疗后１～３个月头部ＣＴ、ＭＲＩ示，影像学上有效率分别为８０％，５０％，以上结果经统计学处理均有明显差异（Ｐ＜０．０１）。在死因分析中，发现Ｘ线立体定向放射治疗加常规放疗组死于头部的比例为２２％比单纯放疗组４９％的低（Ｐ＜０．０５）。而两组病例的放射并发症发生率相似。结论Ｘ线立体定向放射治疗与常规放疗结合治疗脑转移瘤，疗效优于单纯常规放疗
Objective To investigate the role of X-ray stereotactic radiotherapy in conventional radiation therapy of brain metastases. MATERIALS AND METHODS Two groups of patients were matched by the same or similar factors in four prognostic factors (age, KPS score before treatment, whether distant metastasis and solitary metastasis), X-ray stereotactic radiotherapy plus conventional radiotherapy Group 40 cases, conventional radiotherapy group 80 cases, conventional radiotherapy group using whole brain irradiation 30 ~ 40Gy / 3 ~ 4 weeks; X-ray stereotactic radiotherapy plus conventional radiotherapy group, X-ray stereotactic radiotherapy with a single irradiation 27 Cases, graded irradiation in 13 cases, the average target dose of a single target was 13.4Gy, fractional irradiation method for 5 ~ 10Gy / times, twice a week, the total amount of 15 ~ 30Gy. Results X-ray stereotactic radiotherapy and conventional radiotherapy group compared with the conventional radiotherapy group: 1-year survival rates were 50%, 20%; 1-year local control rates were 73%, 15%; KPS score improved after treatment Respectively, 88%, 56%; 1 to 3 months after the treatment of head CT, MRI showed that the imaging efficiency were 80%, 50%, respectively, the results were statistically significant differences (P <0. 01). In the analysis of cause of death, it was found that 22% of X-ray stereotactic radiotherapy plus conventional radiotherapy died of head loss compared with 49% of radiotherapy alone (P <0.05). The incidence of radiation complications in both groups was similar. Conclusion X-ray stereotactic radiotherapy combined with conventional radiotherapy for brain metastases, the effect is superior to conventional radiotherapy alone