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对大脑转移的立体放射手术的预后分析:单中心回顾性研究

Yongping Hao¹, Ting Tang¹, Jing Ren¹

¹Department of Radiation Oncology, The First Affiliated Hospital of China Medical University, No.155 North NanJing Street, Heping District, Shenyang, 110001, Liaoning, China.

La Radiologia medica

|August 30, 2023

概括

大脑转移 (BM) 数量是影响立体性放射性手术 (SRS) 后生存的关键因素. 超过5个脑部瘤表明预后更差,尽管SRS与全脑放射疗法 (WBRT) 结合改善了局部控制.

科学领域:

在瘤学瘤学.
神经外科神经外科
辐射瘤学辐射瘤学

背景情况:

大脑转移 (BM) 是癌症的常见并发症,也是导致死亡的主要原因.
立体辐射手术 (SRS) 是BM的主要治疗方式.
影响SRS BM后结果的预后因素需要进一步阐明.

研究的目的:

为了回顾性地分析治疗SRS治疗BM的患者的内无进展生存率 (iPFS) 和整体生存率 (OS).
确定与SRS后患者预后相关的临床特征.

主要方法:

在2018年至2021年期间,对183名被诊断患有BM并接受SRS治疗的患者进行了回顾性分析.
使用单变量和多变量考克斯回归和卡普兰-梅尔 (KM) 分析来评估预后因素.
研究了临床特征对iPFS和OS的影响.

主要成果:

中位数的IPFS为8.87个月;中位数的OS为16.5个月.
一个BM数≥5是较短的iPFS和OS (HR1.965,p<0.001) 的显著预测指标.
累积内瘤体积 (CITV) ≥2.14 cm3和≥5 BMs的患者具有最差的 iPFS 和 OS. 与单独的SRS相比,SRS加WBRT改善了SRS患者的局部控制>5个BMs (p=0.0357).

结论:

大脑转移的数量 (BM) 是SRS患者的独立预后因素.
患有较大的CITV和较多的BM的患者面临着最糟糕的预后.
将SRS与WBRT结合起来,可以增强患有>5 BMs的患者的局部控制,但不会延长整体存活时间.

关键词:

大脑转移的转移.当地控制局部控制预测预后预测预测在SRS中,它是SRS.

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