Therapeutic Effect Of Stereotactic Puncture Combined With Gamma Knife In The Treatment Of Large Cystic Brain Metastasis

Objeccive The clinical efficacy of stereotactic puncture combined with gamma knife in the treatment of large cystic brain metastasis was studied retrospectively.The purpose of this study was to investigate the short-term clinical remission rate and the improvement of the quality of life of patients with acute space-occupying effect caused by large cystic brain metastasis.The effect of stereotactic puncture on the therapeutic effect of gamma knife was analyzed.In Inner Mongolia,there are few institutions using this method to treat cystic brain metastases.In recent years,there are few cases of treatment.In fact,the cases of cystic brain metastasis are not rare.Therefore,this paper aims to summarize the operation details and the dosage of gamma knife in the treatment of puncture and gamma knife,and so on,in order to promote and guide the treatment of large cystic brain metastasis in local medical institutions.Methods The clinical data of 30 patients with large cystic brain metastasis treated by stereotactic puncture combined with gamma knife from January 1,2013 to January 1,2018 in the head gamma knife center of affiliated Hospital of Inner Mongolia Medical University were analyzed retrospectively.To evaluate the short-term space-occupying effect,tumor control and survival during follow-up.Results We treated 30 eligible patients with 32 lesions.The average volume of tumor before and after puncture was reduced by 60.1%(range: 32.5%-88.1%).The mean KPS score was61.6 before treatment(50-70 points),and the mean KPS score was 76.9(60-90 points)one week after treatment.The chi-square test showed that there was a significant difference between the two groups(P < 0.05).It was proved that the quality of life of the patients improved in a short time after puncture.Follow-up ended on 31 December 2018 with an average follow-up period of 17.7 months(range: 8 to 36 months)with no severe symptoms,the median survival time was 18 months,the overall local control rate was 84.4%at 6 months,and the 1-year survival rate was 70%.Conclusion According to clinical observation and statistical analysis,stereotactic puncture and gamma knife therapy have a significant effect on large cystic brain metastasis and should be regarded as one of the best treatment options,especially for patients with primary tumor control.The treatment of brain metastasis should be more timely and active in order to alleviate the acute space occupying effect in a short time under the condition of minimal invasion,control the growth of tumor,improve the quality of life and prolong the survival time of patients with advanced stage of tumor.In particular,Inner Mongolia region should actively treat eligible patients,on the one hand,it can promote the development of local medical technology,on the other hand,it can alleviate the delay caused by the difficulty of seeking medical treatment.