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目的 探讨Ｘ－ 刀对脑转移瘤的治疗作用及其适应症。方法 对５６例脑转移病人采用Ｘ－ 刀治疗。结果 ４９例病人获得１～２４个月的随访，其随访中位生存期为８．７ 个月，半年局控率为８７．１％ 。Ｘ－ 刀治疗后３个月头颅ＣＴ、ＭＲＩ复查显示肿瘤控制，有效率８４．３８％ （２７／３２），且转移灶体积≤７ｃｍ ３ 与＞ ７ｃｍ ３ 比较有效率明显提高（Ｐ＜ ０．０１）。结论 病人生存率与Ｘ－ 刀治疗前ＫＰＳ评分级别、是否行全脑放疗有关。脑转移瘤是否辅以全脑放疗应视病理和病情而定；对较大的转移灶（直径＞ ３．５ｃｍ ）可采用Ｘ－ 刀分次治疗，以减少并发症发生率。
Objective To investigate the therapeutic effects and indications of X-knife on brain metastatic tumors. Methods X-knife treatment was performed on 56 patients with brain metastases. Results Forty-nine patients were followed up for 1 to 24 months. The median follow-up period was 8.7 months. The half-year control rate was 87.1%. 3 months after X-knife treatment, CT and MRI examinations showed tumor control with an effective rate of 84.38% (27/32). The effective rate of metastasis volume ≤7cm3 and >7cm3 was significantly improved (P<0. 01). Conclusions The patient survival rate is related to the level of KPS scores before X-knife treatment and whether it is performed with whole brain radiation therapy. Whether or not brain metastases are supplemented with whole brain radiotherapy depends on the pathology and condition; for larger metastatic lesions (> 3.5 cm in diameter) X-knife treatment can be used to reduce the incidence of complications.