研究接受立体定向放射外科 (SRS) 治疗的运动皮层脑转移患者的临床、影像和生存结果。影像和临床数据来自我们的前瞻性患者登记处。肿瘤体积从连续成像数据中获得。分析了 2012 年至 2021 年间接受 SRS 的 208 名运动皮层转移患者的结果。总共照射了 279 个转移瘤（0.01 cm3-12.18 cm3，平均 0.74 cm3）。 SRS 边缘剂量范围为 10 至 20 Gy（平均 16.9 Gy）。总体肿瘤控制率为97.8%。就诊时发现 69 例 (25%) 肿瘤存在病灶周围水肿。 6% 的肿瘤中发现了不良放射效应 (ARE)，但只有 1.4% 的肿瘤出现症状。出现 ARE 症状的中位时间为 8 个月。 13% 的患者出现无 ARE 的水肿。 5 名患者 (2%) 出现新的局灶性癫痫发作，1 名患者 (0.3%) 出现新的全身性癫痫发作。 36 名患者 (17%) 出现运动缺陷。最终随访时，32 例（85%）有改善或无变化，13 例（41%）检查正常，10 例（31%）有轻度缺陷，9 例（28%）仍有中度缺陷。中位 8 个月时，31% 的患者发现新的远程脑转移。治疗后，人群卡诺夫斯基表现评分分布整体右移，中位生存期为10个月。偶然发现脑转移的患者比那些出现脑转移的患者有明显更好的生存期（中位 13 个月 vs 9 个月）（P = .048）。不存在神经功能缺损、递归分区分析 I 类和 II 类以及剂量 >18 Gy 均与显着的生存优势相关。针对运动皮层转移的 SRS 对大多数患者来说是安全的，并且可有效控制肿瘤。在神经功能缺损出现之前接受治疗的患者显示出更好的结果。版权所有 © 神经外科医生大会 2023。保留所有权利。

To study the clinical, imaging, and survival outcomes in patients with motor cortex brain metastases treated with stereotactic radiosurgery (SRS).Imaging and clinical data were obtained from our prospective patient registry. Tumor volumes were obtained from serial imaging data.The outcomes of 208 patients with metastases involving the motor cortex who underwent SRS between 2012 and 2021 were analyzed. A total of 279 metastases (0.01 cm3-12.18 cm3, mean 0.74 cm3) were irradiated. The SRS margin dose varied from 10 to 20 Gy (mean 16.9 Gy). The overall tumor control rate was 97.8%. Perilesional edema was noted in 69 (25%) tumors at presentation. Adverse radiation effects (ARE) were noted in 6% of all tumors but were symptomatic in only 1.4%. Median time to appearance of symptomatic ARE was 8 months. Edema without ARE was observed in 13%. New focal seizures were noted in 5 patients (2%) and new generalized seizures in 1 patient (0.3%). Thirty-six patients (17%) presented with motor deficits. At final follow-up, 32 (85%) were improved or unchanged, 13 (41%) had a normal examination, 10 (31%) had mild deficits, and 9 (28%) still had moderate deficits. New remote brain metastases were found in 31% of patients at a median of 8 months. After treatment, the Karnofsky performance score distribution of the population showed an overall right shift and a median survival of 10 months. Patients with incidentally found brain metastases had significantly better survival than those presenting with deficits (median 13 vs 9 months) (P = .048). Absence of a neurological deficit, recursive partitioning analysis Class I and II, and dose >18 Gy were each associated with a significant survival advantage.SRS for motor cortex metastases is safe in most patients and effective in providing tumor control. Patients treated before neurological deficits develop show better outcomes.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.