对于不可切除或转移性黑色素瘤,使用低分离辐射疗法进行持久的局部控制
Sydney A Keatts1, Aya F Salem1, David M Swanson2
1Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
Clinical and translational radiation oncology
|September 23, 2024
概括
剂量升级的低分离辐射疗法 (HFRT) 有效控制了不适合手术或立体RT的庞大黑色素瘤瘤. 这种治疗提供了显著的症状缓解和持久的局部控制与最小的毒性.
科学领域:
- 辐射瘤学 辐射瘤学
- 医学瘤学 医学瘤学
- 黑色素瘤研究 黑色素瘤研究
背景情况:
- 系统治疗的进步增加了晚期黑色素瘤患者的存活率.
- 需要改进的策略来持续控制大型黑色素瘤瘤.
- 由于大小或位置的不同,目前的立体性除性放射疗法 (RT) 可能不适用于所有庞大或不可切除的瘤.
研究的目的:
- 为了评估对无法切除或庞大的转移性黑色素瘤患者进行剂量升级的低分离辐射疗法 (HFRT).
- 评估HFRT提供持久局部控制的能力.
- 为了确定HFRT是否可以改善该患者群体中与瘤相关的症状.
主要方法:
- 在2015年至2022年期间治疗的49名无法切除或庞大的转移性黑色素瘤患者的回顾性评估.
- 对53个瘤点的分析,这些瘤点接受了HFRT的12-17个分数的治疗.
- 临床情景的分类,包括不可切除的局部区域性疾病,寡头转移性/寡头进展性疾病和侵略性息.
主要成果:
- 91%的HFRT目标显示放射性反应 (稳定或减少大小/FDG狂热).
- 98%的症状患者经历了症状的改善.
- 一年的局部控制为79%,两年无进展生存率为33%,整体生存率为39%.
- 常见的急性毒性包括辐射皮肤炎 (16%),疼痛发作 (14%);晚期毒性不常见且低度.
结论:
- 低分离辐射疗法 (HFRT) 证明了对不适合切除或立体RT的黑色素瘤瘤的有利局部控制.
- 高FRT为患有晚期或大容量黑色素瘤的患者提供了显著的症状缓解.
- 该治疗与有限的毒性有关,使其成为选择患者的可行选择.
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