立体性身体放射疗法没有系统治疗的Oligometastatic癌症:一个系统的审查和元分析
Jonas Willmann1,2, Camilla von Wachter1, Ronja Zehnder1
1Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
JAMA network open
|February 3, 2026
概括
以转移为导向的立体体辐射疗法 (SBRT) 单独提供了一个可行的替代方案,用于系统治疗小细胞转移性癌症,实现高系统治疗无生存率 (STFS),特别是细胞和前列腺癌,与最小的严重不良事件.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 医学物理 医学物理
背景情况:
- 在选择治疗时,Oligometastatic癌症是一个挑战,它需要平衡疗效与全身疗法的潜在毒性.
- 转移导向的立体性身体放射疗法 (SBRT) 正在成为一种延迟特定患者全身治疗的策略.
- 需要对SBRT在推迟全身治疗中的作用进行全面的证据评估.
研究的目的:
- 为了评估单独SBRT后在各种寡头转移性癌症中无系统治疗生存率 (STFS).
- 量化转移导向SBRT后的不良事件,生活质量和整体瘤结果.
- 确定SBRT作为前期全身疗法的替代方案的疗效.
主要方法:
- 在PubMed和EMBASE的系统文献搜索2009年以后发表的研究.
- 包括回顾性或前性研究,包括≥10名接受转移导向SBRT用于小转移性癌症 (≤5个转移) 的患者.
- 使用随机效应模型对1年或2年的STFS发病率进行元分析,遵循PRISMA指南.
主要成果:
- 分析包括13项研究 (984名患者),在癌症类型中,1年或2年的STFS总率为69.7%.
- 细胞癌 (87.0%) 和前列腺癌 (78.1%) 显示STFS的发病率最高.
- 严重的不良事件 (等级≥3) 是不常见的,在观察它们的研究中报告了1.9%-8.8%的患者;79%的研究报告没有≥3级不良事件.
结论:
- 转移导向的SBRT单独与显著的STFS有关,特别是在寡头转移性细胞和前列腺癌中.
- 在SBRT之后,与治疗相关的严重不良事件的风险很低.
- 单独的SBRT可能代表一个可接受的替代方案,以立即的全身疗法,精心挑选的患者与小分子转移性癌症.
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