運動麻痺をきたす転移性脳腫瘍のガンマナイフ治療

概要

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Object: One hundred and four patients suffering from hemiparesis with the metastatic brain tumors were treated with gamma knife radiosurgery (GKRS), and were analyzed from the point of view of recovery of hemiparesis, side effects and local recurrence. Methods: The tumors, ranging from 0.2 to 30.0 ml (mean 7.6m1), were treated with gamma knife of marginal radiation dose of 20-30Gy(mean 26.7Gy). The hemiparesis was evaluated with MMT grade. Results: Cumulative survival rate at 1 year was 25% and median survival time was 6 months. After GKRS, 98/104 (95.2%) patients recovered hemiparesis and had independent life to terminal stage. Eighty percents of the patients fully recovered from hemiparesis at 2 months after GKRS and were free until 6 months after GKRS. No factors such as tumor location, volume, the degree of perifocal edema, maximum and marginal radiation dose were significant in influencing improvement of hemiparesis. Delayed radionecrosis with deteriorated hemiparesis was occurred in 11 cases (10.6%). Reduction rates of tumors at 2 (p=0.0002) and 3 months (p=0.0016) after GKRS were significant factors to radionecrosis. Conclusions: Metastatic brain tumors were well controlled by gamma knife radiosurgery, even if the tumors located in the motor cortex, with reasonable rates of radionecrosis, and the patients developed rapid recovery from hemiparesis, which could contributed to the patient QOL with limited life expectancy.
2001-12-20