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脑转移患者的死亡原因

Zane Schnurman¹, Elad Mashiach¹, Katherine E Link¹

¹Department of Neurosurgery, NYU Langone Health, New York , New York , USA.

|May 31, 2023

概括

大多数脑转移患者的死亡是系统性疾病进展造成的,而不是中枢神经系统 (CNS) 疾病. 无法控制的系统性疾病和新的脑瘤,而不是局部瘤生长,驱动神经系统衰退和死亡.

科学领域:

神经瘤学神经瘤学
医学瘤学医学瘤学
放射性外科手术是如何进行的

背景情况:

立体辐射手术 (SRS) 和向疗法改善了大脑转移的结果.
对于这些患者死亡率的主要驱动因素的了解有限.
描述死亡原因和内瘤动态对于指导管理和研究至关重要.

研究的目的:

确定脑转移患者死亡的主要原因.
为了评估死亡患者和幸存者之间内瘤动态的差异.

主要方法:

利用了NYUMets-Brain数据集,这是一个大型的,纵向的,现实世界的数据集.
审查了2012年至2021年期间接受SRS治疗的患者的电子健康记录.
使用多层模型对死亡原因进行分类并分析内瘤体积和数量变化.

主要成果:

73.1%的死亡是由于系统性疾病,10.3%是由于中枢神经系统疾病,16.6%是由于其他原因.
中枢神经系统死亡的主要原因是内瘤负担增加 (60%),神经学缺陷 (18%) 和发作 (11%).
与幸存者相比,在死亡的患者中,新的内瘤的发生率几乎是死亡患者的两倍 (P < .001).

结论:

系统性疾病进展是脑转移患者死亡的主要原因.
对于与中枢神经系统相关的死亡,由系统性疾病驱动的新瘤向大脑扩散似乎是主要因素.
管理策略应考虑系统性疾病控制对神经结果的影响.

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