息全脑辐射疗法:国际实践现状
Emily Keit1, Shing Fung Lee2, Melissa Woodward3
1Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
Annals of palliative medicine
|September 21, 2023
概括
息性全脑放射治疗 (WBRT) 仅适用于预后不佳的患者,平均存活时间为84天. 这证实了WBRT的存在.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 辐射输送和全身疗法的进步减少了整脑息性辐射疗法 (WBRT) 的适用性.
- 现在偏好立体辐射疗法 (SRT),而WBRT只适用于特定的复杂病例,如>15个病变或膜病.
- 尽管WBRT协议的变化,生存率仍然很差,支持在特定情况下适当使用.
研究的目的:
- 分析目前的全球实践和整脑息性辐射疗法 (WBRT) 的生存结果.
- 在先进的全身疗法和SRT时代评估患者选择和治疗变化.
- 评估WBRT在预后生存有限的患者中的有效性.
主要方法:
- 一个多中心,从2022年起对息性WBRT病例的国际回顾性分析.
- 不包括用于治疗,预防或弥合目的的WBRT.
- 卡普兰-梅尔法用于计算WBRT后的整体存活率 (OS).
主要成果:
- 在10个国际中心的29,943份RT处方中,只有1.5%用于息性WBRT.
- 平均生存期为84天;6个月生存率为32%.
- 剂量方案 (26种类型) 的区域差异显著,神经认知节省技术的使用有限 (例如,海马避开在9.5%).
结论:
- 息性WBRT适用于预期存活时间较低的患者,这反映了其减少的适用性.
- 在WBRT中存在显著的全球实践差异.
- 由于整体存活率较低,记忆素和海马避开最适合于经过仔细选择的患者.
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