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目的:观察5个以上多发脑转移瘤的立体定向放射外科治疗(SRS)的副反应及联合全脑放射治疗(WBRT)的疗效。方法:回顾性分析2007年6月至2011年12月间,7例病灶数5个以上多发脑转移瘤患者接受SRS的毒副反应及联合WBRT治疗效果。结果:3例出现急性放疗反应导致颅压升高,经过加强甘露醇和地塞米松治疗后症状缓解;治疗结束后1月进行评估:7例KPS均提高,中枢神经系统症状消失5例,部分缓解2例;甘露醇和地塞米松停用3例,用量减少4例;放疗结束后3个月复查增强MRI,CR1例,PR 5例,PD1例,RR85.7%;随访截止2012年9月,6例死亡,中位生存时间为8个月。结论:5个以上多发脑转移瘤,无严重颅内高压患者,行SRS联合WBRT治疗基本可耐受,可能使患者0S获益,可作为首选姑息治疗手段,但需要进一步研究。
Objective: To observe the efficacy of stereotactic radiosurgery (SRS) and combined whole brain radiation therapy (WBRT) in more than five brain metastases. Methods: A retrospective analysis was conducted between June 2007 and December 2011 in which seven patients with multiple brain metastases with more than 5 lesions had toxic side effects and combined with WBRT. Results: In 3 cases, acute intracranial pressure resulted in the increase of intracranial pressure. The symptoms were relieved after mannitol and dexamethasone were intensively treated. After the end of treatment, the results were evaluated in January: 7 cases of KPS increased, 5 cases of central nervous system symptoms disappeared, and partial response (N = 2), mannitol and dexamethasone were discontinued in 3 cases, and the dosage was decreased in 4 cases. MRI was enhanced in 3 months after the end of radiotherapy. CR1, PR5, PD1, RR85.7% 6 died, the median survival time was 8 months. CONCLUSIONS: More than 5 patients with multiple brain metastases without severe intracranial hypertension, who are treated with SRS combined with WBRT, may be regarded as the first choice of palliative treatment. However, further study is needed.