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对患有脑转移从非小细胞肺的主要免疫疗法或向疗法患者的立体射线手术剂量减少
Jared H Chung1,2, Salem M Tos2, Georgios Mantziaris2
1University of Virginia School of Medicine, Charlottesville, Virginia, USA.
Neurosurgery
|February 12, 2026
概括
对非小细胞肺癌 (NSCLC) 大脑转移的降低剂量立体辐射手术 (SRS) 与全身疗法并发,降低了不良辐射事件,而不影响局部控制. 这种方法可能为患者提供更安全的治疗选择.
科学领域:
- 在瘤学瘤学.
- 辐射瘤学 辐射瘤学
- 神经学 神经学
背景情况:
- 非小细胞肺癌 (NSCLC) 的脑转移很常见.
- 立体辐射手术 (SRS) 改善了局部控制,但可以增加不良辐射事件 (ARE).
- 同时的全身疗法越来越多地与SRS用于NSCLC大脑转移.
研究的目的:
- 评估是否减少SRS剂量可以保持局部控制,同时最大限度地减少NSCLC脑转移中的毒性.
- 为了比较高剂量 (HD) 和低剂量 (RD) SRS之间的AREs和局部控制.
- 评估并发性全身疗法 (免疫疗法或向疗法) 对结果的影响.
主要方法:
- 对264名肺部原发性脑转移患者进行了回顾性研究,这些患者接受了SRS治疗.
- 专注于82名接受并发全身治疗的NSCLC患者.
- 倾向性得分匹配创建了HD (n=38) 和RD (n=42) 组进行比较.
主要成果:
- 降低剂量的SRS显示显著较低的放射性AREs (10.8%),相比较高剂量的SRS (23.7%).
- 在 RD 组 (94.6%) 和 HD 组 (90.3%) 之间,局部控制是不劣的.
- 在RD和HD组之间,1,3年和5年的累积进展率在RD和HD组之间是可比的.
结论:
- 与免疫疗法或向疗法并发的降低剂量的SRS是NSCLC脑转移的可行选择.
- 这种策略可以在不牺牲当地控制的情况下减少AREs.
- 在当前的系统疗法时代,RD SRS提供了一个潜在的更安全的治疗范式.
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