Influence Factors On Early Therapeutic Effect Of Brain Metastases Undergoing Gamma Knife

BackgroundBrain metastases are intracranial neoplasm that origin from other parts of the body which invade into brain through channels such as the blood circulation,and is one of the most common tumors of the central nervous system,which accounting for about 10%of all intracranial tumors.In recent years,with the progress of imaging technology to improve the detection rate and the development of malignant tumor treatment technology,the survival time of patients has been prolonged and the incidence of brain metastases has increased.Brain metastases are usually of high grade malignancy,Once the diagnosis established,it means the terminal stage of the disease with poor prognosis.Previous treatment methods,such as surgery,radiation therapy,can improve the prognosis of patients to a certain extent,but at the same time because of their limited indications,complications and other reasons,their application are limited.The progressive development of stereotactic radiography(SRS),which is represented by Gamma Knife,provides a new treatment for brain metastases.Gamma knife can improve the radiation dose of local tumor tissue with less injury of normal brain,high efficiency and less side effects,which has been widely used in recent years.Leksell Gamma Knife Perfexion was introduced by the Second Hospital of Shandong University from Sweden.From May 20 to January 2017,50 cases of brain metastases were treated with Gamma Knife,and the effect was good.This study collected the clinical data of these patients to assess the short-term efficacy,and the relevant factors to do a preliminary study.ObjectiveTo investigate the early therapeutic effect and related influencing factors of Gamma knife in the treatment of brain metastases.MethodsA total of 50 patients with brain metastases treated from May 2016 to February 2017 were retrospectively analyzed.Age,sex,pre-treatment KPS score,pre-treatment GPA score,whether important parts were involved,whether combined with other extracranial metastases,whether the primary tumor and the brain metastases were found in the same period were summarized as influencing factor.The follow-up was evaluated at 3 months after operation.The relationship between the influencing factors and the early therapeutic effect was analyzed by chi-square test.Result15(30%),11(22%),16(32%),8(16%)cases were complete remission,partial remission,no change and progression respectively.26 patients(52%)had a good effect and 24 patients(48%)had poor effect.Chi-square test showed the early therapeutic effect was significantly related to pre-treatment KPS score,pre-treatment GPA score,whether important parts were involved and whether the primary tumor and the brain metastases were found in the same period,while age,gender and whether combined with other extracranial metastases has no relevance.No serious adverse events were observed after operation.Conclusions:1.Gamma knife is high efficiency with excellent early therapeutic effect and less side effects in the treatment of brain metastases.2.The early therapeutic effect of gamma knife in the treatment of brain metastases was related to pre-treatment KPS score,pre-treatment GPA score,whether important parts were involved and whether the primary tumor and the brain metastases were found in the same period.