摘要
目的：回顾本院近３年来伽玛刀治疗脑转移瘤的情况，阐明其治疗的有效性，研究影响患者预后的相关因素。方法：回顾性调查１９９３年１０月～１９９５年１１月治疗的１５３例脑转移瘤患者（３７２个病灶）。平均年龄为５７岁，平均卡氏评分６７％，平均随访时间２４个月。通过Ｃｏｘ多元回归分析影响生存时间的１３个因素。统计学上有显著的差异Ｐ＜０．０５。结果：术后平均生存时间为８．５个月。多元统计分析原发肿瘤稳定，卡氏评分大于７０％，病灶３个或更少以及全身化疗加原发肿瘤切除这四个因素能明显延长生存时间（Ｐ＜０．０５），由此引入一个五级评分系统来预测患者的生存时间（每个因素为１分，分别为４，３，２，１，０分）。４分患者有１２个月存活时间，３分１０个月，２分６个月，１分３个月，０分１个月。结论：伽玛刀是一种安全有效适用于中、小体积。
Objective: To review the treatment experience with Gamma kinfe for radiosurgery metastasis in our hospital for 3 years in order to improve the effectiveness of the treatment and to find the related factors which affect the prognoses. Methods:Retrospective analysis 153 patients (372 lesions) treated between October 1993 and December 1995. The study population had a median age of 57 years and a median Karnofsky Performance Score (KPS) of 67% before radiosurgery. Median followup period was 24 months. The Cox regression model was used to study the effects of multiple covariates (13 factors) on patients' suvival. Statistical significance was defined as P<005. Results: Median overall survival time after gamma knife therapy was 85 months. Through the analysis of multiple covariates, the adsence of active systemic disease, KPS more than 70%, three or fewer lesions and chemotherapy plus the resection of the primary tumor were significantly associated with increased survival time (P<005). These four factors were used to develop a grading system (grades I～V). Patients categorized in grade V had a 12 months median survival time, whereas the median survival time of patients in grades IV, III, II and I was 10, 6, 3 and 1 month, respectively. Conclusion: The results show that Gamma knife radiosurgery is an effective, minimally invasive treatment option for smaller intracranial metastases of patients who are categorized in higer than grade I.
出处
《中华神经外科杂志》
CSCD
北大核心
1998年第3期148-150,共3页
Chinese Journal of Neurosurgery
