CT和MRI图像融合下行HA-WBRT或HA-SRT对脑转移瘤患者的疗效及认知功能的影响

doi:10.3969/j.issn.1671-7171.2025.12.012

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摘要 【目的】探讨CT和MRI图像融合下行海马保护性全脑放疗(HA-WBRT)或海马保护性脑立体定向放疗(HA-SRT)对脑转移瘤患者的疗效和认知功能的影响。【方法】评估40例行HA-WBRT或HA-SRT的脑转移瘤患者治疗6个月后的临床疗效及安全性,比较患者治疗前与治疗后1个月、3个月和6个月认知功能和生活质量。【结果】治疗后6个月,患者的总有效率为75.00%(30/40),总生存率为90.00%(36/40),疾病控制率为87.50%(35/40)。治疗后1个月、3个月和6个月认知功能正常患者的比例与治疗前比较,差异均无统计学意义(P>0.05)。治疗后1个月,患者的简易精神状态检查(MMSE)评分与治疗前比较,差异无统计学意义(P>0.05),治疗后3个月和6个月患者的MMSE评分均高于治疗前(P<0.05),治疗后不同时间点MMSE评分两两比较,差异均无统计学意义(P>0.05)。治疗后1个月、3个月和6个月患者的生命质量评分依次降低,均低于治疗前(P<0.05),且治疗后各时间点两两比较,差异均有统计学意义(P<0.05)。【结论】CT和MRI图像融合下行HA-WBRT或HA-SRT治疗脑转移瘤患者的疗效较好,可显著降低患者认知功能损伤风险,改善生活质量。

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	吴娅丽
	蔡利红

关键词 ：肿瘤转移, 脑肿瘤, 体层摄影术, 螺旋计算机, 磁共振成像, 放射疗法, 影像引导

Abstract：【Objective】 To investigate the efficacy and impact on neurocognitive function of hippocampal-avoidance whole-brain radiotherapy (HA-WBRT) or Hippocampal-Avoidance stereotactic radiotherapy(HA-SRT) guided by CT and MRI image fusion in patients with brain metastases.【Methods】 Forty patients with brain metastases who underwent HA-WBRT were evaluated for clinical efficacy and safety six months after treatment. Neurocognitive function and quality of life (QoL) were compared before treatment and at 1, 3, and 6 months after treatment.【Results】 At 6 months post-treatment, the overall response rate was 75.00% (30/40), the overall survival rate was 90.00% (36/40), and the intracranial progression-free rate was 87.50% (35/40). There were no statistically significant differences in the proportion of patients with normal cognitive function before and at 1, 3, and 6 months after treatment (P>0.05). One month after treatment, there was no statistically significant difference in the patients' Mini-Mental State Examination (MMSE) scores compared with those before treatment (P>0.05). At 3 and 6 months after treatment, the patients' MMSE scores were higher than those before treatment (P<0.05). There were no statistically significant differences in MMSE scores at different time points after treatment (P>0.05). The QoL scores decreased progressively at 1, 3, and 6 months after treatment; And all QoL scores were significantly lower than before treatment (P<0.05), with significant differences among those post-treatment time points (P<0.05).【Conclusion】 CT/MRI image fusion-guided HA-WBRT or HA-SRT demonstrates favorable therapeutic efficacy in patients with brain metastases, effectively reducing the risk of neurocognitive impairment and improving quality of life.

Key words： Neoplasm Metastasis Brain Neoplasms Tomography, Spiral Computed Magnetic Resonance Imaging Radiotherapy, Image-Guided

收稿日期: 2025-05-29

中图分类号:

R739.41

基金资助:2022年度开封市科技发展计划项目(2203121)

通讯作者: **E-mail:494610210@qq.com

引用本文:

吴娅丽, 蔡利红. CT和MRI图像融合下行HA-WBRT或HA-SRT对脑转移瘤患者的疗效及认知功能的影响[J]. 医学临床研究, 2025, 42(12): 2057-2060.
WU Yali, CAI Lihong. Effect of Hippocampal-Avoidance Radiotherapy or Hippocampal-Avoidance Stereotactic Radiotherapy under CT and MRI Image Fusion on the Efficacy and Cognitive Function in Patients with Brain Metastases. JOURNAL OF CLINICAL RESEARCH, 2025, 42(12): 2057-2060.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.12.012 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I12/2057

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