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目的:探讨采用三维适形放射治疗肺癌脑转移的临床效果。方法:回顾性分析我院2010年12月至2011年2月治疗的60例肺癌脑转移患者的临床资料,对其行全脑放疗联合三维适形放射治疗后,统计和分析患者肿瘤的局部控制率、中位生存期及急慢性放疗的副反应。结果:本组患者治疗后,肿瘤完全缓解者20例,肿瘤部分缓解者31例,肿瘤稳定者5例,肿瘤进展者4例,肿瘤局部控制率达85.0%;中位生存期10.5月。本组中有2例表现为精神方面的症状加重而停止治疗,有2例记忆力减退较为明显,有3例发生了脑水肿和出血症状,经降颅压治疗获得好转,其他患者均有程度较轻的副反应,不影响正常治疗,患者可以耐受。结论:治疗肺癌脑转移时,在加强对原发灶治疗的同时,采用全脑放射治疗联合三维适形放射治疗,能够提高脑转移的靶区剂量,进而提高肿瘤局部控制率,使脑部复发的机会减少,显著提高患者的中位生存期,减轻急慢性放疗产生的副反应。
Objective: To investigate the clinical effect of three-dimensional conformal radiotherapy for brain metastasis of lung cancer. Methods: The clinical data of 60 patients with brain metastases from lung cancer treated in our hospital from December 2010 to February 2011 were analyzed retrospectively. After they were treated with whole brain radiotherapy and three-dimensional conformal radiotherapy, the local control of the tumor was statistically analyzed Rate, median survival and acute and chronic radiation side effects. Results: After treatment, 20 patients with complete tumor remission, 31 patients with partial tumor remission, 5 patients with stable tumor, 4 patients with tumor progression, and 85.0% local tumor control rate. The median survival time was 10.5 months. In this group, 2 patients showed symptoms of psychosis to stop treatment, there are two cases of memory loss was more obvious, there were three cases of cerebral edema and hemorrhagic symptoms, by reducing intracranial pressure treatment improved, the other patients were more degree Light side effects, does not affect the normal treatment, patients can tolerate. Conclusions: When treating brain metastases of lung cancer, the whole brain radiation therapy combined with three-dimensional conformal radiotherapy can enhance the target dose of brain metastasis while enhancing the treatment of primary tumor, and then increase the local control rate of tumor and make brain recurrence Reduce the opportunity to significantly improve the patient’s median survival and reduce the side effects of acute and chronic radiotherapy.