| Objective To evaluate the clinical efficacy of body gamma knife in the treatment of liver metastases,lung metastases,and adrenal metastases.Methods We collected data on liver metastases,lung metastases,and adrenal metastases that were treated with body gamma knife treatment in our hospital from January 2016 to June2019.After sorting and enrolling,the data was complete and the diagnosis was liver metastases and lung metastases.A total of 71 patients with tumors and adrenal metastases,a total of 119 metastases were treated with gamma radiation,including 12 liver metastases(22liver metastases),46 lung metastases(70 lung metastases),and adrenal metastases 13 cases of tumor(26 metastases).Collect basic information such as the patient’s name,gender,age,KPS score,lesion location,stage,whether they have received other treatments in the past,treatment time,dose,and dose division mode;collect the patient’s blood routine,liver and kidney function before,during and after treatment Test results of ions,tumor markers,etc.are available for analysis.The dose division modes of gamma knife treatment are: the dose for patients with liver metastases: 3～8Gy/F×5～14F;the dose for patients with lung metastases:3～8Gy/F×5～18F;the dose for patients with adrenal metastases: 3～5Gy/F×8～18F;5times/week;all use the 50% dose line as the prescribed dose.Afterwards,follow-up records were performed as required,and the short-term efficacy,1-year local control rate(LCR),survival rate(Over survival,OS),side effects,and factors related to prognosis were statistically analyzed in 3 months after the end of treatment.Results(1)The effective rate of treating 3 kinds of metastases for 3 months was 72%;the1-year overall survival rate was 83.1%;the local control rate was 97.5%;the 1-year survival rate and the local control rate of liver metastases were respectively 58.3% and 95.5%;the1-year survival rate and local control rate of lung metastases were 84.7% and 97.1%,respectively;the 1-year survival rate and local control rate of adrenal metastases were 100%and 96.2%,respectively.Among the 46 patients with lung metastases,17 patients were treated with 3～4Gy/F×10～18F;29 patients were treated with 5～8Gy/F×5～14F.The results showed that the median survival time of patients with a large single dose Longer.Among 71 patients,10 survived and 61 died as of January 30,2021;of these,26(36.6%)died of myocardial infarction,pulmonary heart disease,cerebral hemorrhage and other medical diseases,and 28(39.4%)died of Tumor recurrence and metastasis.There were also 7 deaths(9.9%)of unknown cause.(2)Multivariate analysis showed that age,treatment site,and other sites of metastasis are the main factors affecting the prognosis.Compared with patients aged ≥70,the risk of death of the former is 2.75 times that of the latter,(P=0.001);the treatment site of liver metastases is21.967 times that of lung metastases,the treatment site of lung metastases is 5.953 times of adrenal metastases(P<0.001),and the metastasis of other sites is 2.885 times that of no other sites(P <0.001).(3)Side effects: During radiotherapy,10(14.08%)cases had mild gastrointestinal reactions,such as nausea and vomiting;20(28.17)cases had cough and sputum,without special treatment.Six months after the end of treatment(8.45%)patients developed fibrosis in the radiotherapy area,there were no other adverse reactions,and normal life was not affected.Conclusions(1)Gamma knife treatment of advanced liver metastases,lung metastases,and adrenal metastases has a high survival rate and small side effects,which is safe and effective;(2)The treatment of lung metastases adopts a segmentation mode with a large single dose and few times,which will prolong the survival time of patients.(3)The main factors affecting the prognosis of advanced metastatic tumors are age,treatment site,and whether it is accompanied by other sites of metastasis. |
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