脑转移瘤立体定向放射治疗进展

张中民

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脑转移瘤立体定向放射治疗进展

  • 中图分类号: R445.2

Progress in stereotactic radiotherapy for patients with brain metastases

  • CLC number: R445.2

  • 摘要: MRI在脑转移瘤的诊断、治疗以及随访中有重要作用。原发灶状况、脑转移瘤的体积、立体定向放疗前后是否加全脑放疗、一般状况评分、回归分割分析(RPA)分级、是否存在颅外转移等是影响脑转移瘤治疗效果的主要因素。单纯立体定向放疗逐渐成为脑转移瘤治疗的主流,分次立体定向放疗在脑转移瘤治疗中的作用尚未完全明确。
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    [2] Suzuki K, Yamamoto M, Hasegawa Y, et al. Magnetic resonance imaging and computed tomography in the diagnosis of brain metastases of lung cancer[J]. Lung Cancer, 2004, 46(3):357-360.
    [3] Shehata MK, Young B, Reid B, et al. Stereotatic radiosurgery of 468brain metastases ≤ 2 cm:implications for SRS dose and whole brain radiation therapy[J]. Int J Radiat Oncol Biol Phys, 2004, 59(1):87-93.
    [4] Aoyama H, Shirato H, Onimaru R, et al. Hypofractionated stereotactic radiotherapy alone without whole-brain irradiation for patients with solitary and oligo brain metastasis using noninvasive fixation of the skull[J]. Int J Radiat Oncol Biol Phys, 2003, 56(3):793-800.
    [5] Varlotto JM, Flickinger JC, Niranjan A, et al. Analysis of tumor control and toxicity in patients who have survived at least one year after radiosurgery for brain metastases[J]. Int J Radiat Oncol Biol Phys, 2003, 57(2):452-464.
    [6] Sneed PK, Sub JH, Goetsch SJ, et al. A multi-institutional review of radiosurgery alone vs. radiosurgery with whole brain radiotherapy as the initial management of brain metastases[J]. Iht J Radiat Oncol Biol Phys, 2002, 53(3):519-526.
    [7] Chidel MA, Suh JH, Reddy CA, et al. Application of recursive partitioning analysis and evaluation of the use of whole brain radiation among patients treated with stereotactic radiosurgery for newly diagnosed brain metastases[J]. Int J Radiat Oncol Biol Phys,2000, 47(4):993-999.
    [8] Gaspar L, Scott C, Rotman M, et al. Recursive partitioning analysis (RPA)of prognostic factors in three radiation therapy oncology group (RTOG)brain metastases trial[J]. J Radiat Oncol Biol Phys,1997, 37:745-751.
    [9] Kondziolka D, Patel A, Lunsford LD, et al. Stereotactic radiosurgery plus whole brain radiotherapy versus radiotherapy alone for patients with multiple brain metastases[J]. Iht J Radiat Oncol Biol Phys, 1999, 45(2):427-433.
    [10] Andrews DW, Scott CB, Sperduto PW, et al. Whole brain radiation therapy with or without Stereotactic radiosurgery boost for patients with one to three brain metastases:phase Ⅲ results of the RTOG9508randomised trial[J]. Lancet, 2004, 363(9422):1665-1672.
    [11] Sneed PK, Lamborn KR, Forstner JM, et al. Radiosurgery for brain metastases:is whole brain radiotherapy necessary?[J]. Int J Radiat Oncol Biol Phys, 1999, 43(3):549-558.
    [12] Jawabar A, Willis BK, Smith DR, et al. Gamma knife radiosurgery for brain metastases:do patients benefit from adjuvant externalbeam radiotherapy? An 18-month comparative analysis[J]. Sterotact Funet Neurosurg, 2002, 79(3):262-271.
    [13] Chitapanarux I, Goss B, Vongtama R, et al. Prospective study of stereotactic radiosurgery without whole brain radiotherapy in patients with four or less brain metastases:incidence of intracranial progression and salvage radiotherapy[J]. J Neurooncol, 2003, 61(2):143-149.
    [14] Regine WF, Huhn JL, Patehell RA, et al. Risk of symptomatic brain tumor recurrence and neurologic deficit after radiosurgery alone in patients with newly diagnosed brain metastases:results and implications[J]. Iht J Radiat Oncol Biol Pbys, 2002, 52(2):333-338.
    [15] Lutterbach J, Cyron D, Henne K, et al. Radiosurgery followed by planned observation in patients with one to three brain metastases[J]. Neurosurgery, 2003, 52(5):1066-1074.
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  • 收稿日期:  2004-11-30

脑转移瘤立体定向放射治疗进展

  • 276003 临沂, 山东省临沂市人民医院放疗中心

摘要: MRI在脑转移瘤的诊断、治疗以及随访中有重要作用。原发灶状况、脑转移瘤的体积、立体定向放疗前后是否加全脑放疗、一般状况评分、回归分割分析(RPA)分级、是否存在颅外转移等是影响脑转移瘤治疗效果的主要因素。单纯立体定向放疗逐渐成为脑转移瘤治疗的主流,分次立体定向放疗在脑转移瘤治疗中的作用尚未完全明确。

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