脑转移患者的立体性放射性手术后90天生存的预后因素
Ali Gharibi Loron1, William D Chow2, Andrew D Pumford2
11Department of Neurological Surgery, Mayo Clinic, Rochester.
Journal of neurosurgery
|January 22, 2026
概括
经过脑转移的立体射线手术 (SRS) 后90天生存的预测因素包括功能状况不佳和神经学缺陷. 系统性癌症控制和缺乏中枢神经系统进展改善了生存率,有助于患者选择SRS.
科学领域:
- 神经瘤学神经瘤学
- 辐射瘤学 辐射瘤学
- 医学统计 医学统计
背景情况:
- 大脑转移显著影响患者的生存和神经认知功能.
- 立体辐射手术 (SRS) 是有限的大脑转移的标准治疗方法.
- 尽管有SRS,但很大一部分患者在90天内死亡.
研究的目的:
- 为了确定大脑转移SRS后90天生存的预后因素.
- 为了提高患者选择SRS治疗.
主要方法:
- 对1546名接受玛刀SRS (2015-2023) 的患者进行了回顾性分析.
- 170名患者的病例匹配比较,<90天生存率与170名患者的90天生存率相比较.
- 二项式和多变量逻辑回归建模.
主要成果:
- 较差的卡诺夫斯基绩效得分 (KPS) < 70,之前的全脑辐射和焦点神经缺陷预测了生存率较低.
- 在SRS和全身癌症控制之前,中枢神经系统 (CNS) 的进展与改善的生存率有关.
- 预测模型显示AUC为0.85,准确度为80%,灵敏度为87%,特异性为71%.
结论:
- 功能状态 (KPS),全身癌症控制,中枢神经系统进展和神经缺陷是90天生存的关键预测因素.
- 这些因素可以帮助优化患者对SRS的选择.
- 改善患者选择可能会改善脑转移患者的治疗结果.
更多相关视频
06:52The Establishment and Utilization of Patient Derived Xenograft Models of Central Nervous System Metastasis
Published on: May 7, 2021
2.8K
08:02A High-Throughput Image-Guided Stereotactic Neuronavigation and Focused Ultrasound System for Blood-Brain Barrier Opening in Rodents
Published on: July 16, 2020
5.4K
相关概念视频
Factors Affecting Protein-Drug Binding: Patient-Related Factors
312
Protein-drug binding, a pivotal aspect of pharmacokinetics, is subject to considerable variability influenced by an array of patient-related factors. The intricate interplay of age, individual differences, and pathological conditions significantly impact the binding dynamics and subsequent pharmacological effects.
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...
312
Metastasis
6.4K
Metastasis is the spread of cancer cells from the original site to distant locations in the body. Cancer cells can spread via blood vessels (hematogenous) as well as lymph vessels in the body.
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...
6.4K
Survival Tree
407
Survival trees are a non-parametric method used in survival analysis to model the relationship between a set of covariates and the time until an event of interest occurs, often referred to as the "time-to-event" or "survival time." This method is particularly useful when dealing with censored data, where the event has not occurred for some individuals by the end of the study period, or when the exact time of the event is unknown.
Building a Survival Tree
Constructing a...
Building a Survival Tree
Constructing a...
407
Survival Curves
684
Survival curves are graphical representations that depict the survival experience of a population over time, offering an intuitive way to track the proportion of individuals who remain event-free at each time point. These curves are widely used in fields such as medicine, public health, and reliability engineering to visualize and compare survival probabilities across different groups or conditions.
The Kaplan-Meier estimator is the most common method for constructing survival curves. This...
The Kaplan-Meier estimator is the most common method for constructing survival curves. This...
684
Introduction To Survival Analysis
766
Survival analysis is a statistical method used to study time-to-event data, where the "event" might represent outcomes like death, disease relapse, system failure, or recovery. A unique feature of survival data is censoring, which occurs when the event of interest has not been observed for some individuals during the study period. This requires specialized techniques to handle incomplete data effectively.
The primary goal of survival analysis is to estimate survival time—the time...
The primary goal of survival analysis is to estimate survival time—the time...
766
Comparing the Survival Analysis of Two or More Groups
579
Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
579
