Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Anticancer Res. 2014 Sep;34(9):5079-82.
BACKGROUND/AIM: To compare different doses of stereotactic radiosurgery (SRS) for 1-3 newly-diagnosed cerebral metastases from melanoma.
Fifty-four patients were assigned to dose groups of 20 Gy (N=36) and 21-22.5 Gy (N=18). Variables additionally analyzed were age, gender, Karnofsky Performance Score (KPS), lactate dehydrogenase (LDH) before SRS, number of cerebral lesions, extracranial lesions, time from melanoma diagnosis to SRS.
The 12-month local control was 72% after 20 Gy and 100% after 21-22.5 Gy (p=0.020). Freedom from new cerebral metastases (p=0.13) and survival (p=0.13) showed no association with SRS dose. On multivariate analyses, improved local control showed significant associations with SRS doses of 21-22.5 Gy (p=0.007) and normal lactate dehydrogenase levels (p=0.018). Improved survival was associated with normal LDH levels (p=0.006) and KPS 90-100 (p=0.046).
SRS doses of 21-22.5 Gy resulted in better local control than 20 Gy. Freedom from new brain metastases and survival were not significantly different.
背景/目的：比较 1-3 个新诊断的脑转移瘤来自黑色素瘤的立体定向放射外科（SRS）的不同剂量。
54 名患者被分配到 20 Gy（N=36）和 21-22.5 Gy（N=18）剂量组。此外还分析了年龄、性别、卡诺夫斯基表现评分（KPS）、SRS 前乳酸脱氢酶（LDH）、脑病变数量、颅外病变、从黑色素瘤诊断到 SRS 的时间等变量。
20 Gy 后 12 个月局部控制率为 72%，21-22.5 Gy 后为 100%（p=0.020）。新脑转移（p=0.13）和生存（p=0.13）与 SRS 剂量无关联。多变量分析显示，局部控制的改善与 SRS 剂量为 21-22.5 Gy（p=0.007）和正常乳酸脱氢酶水平（p=0.018）显著相关。生存的改善与正常 LDH 水平（p=0.006）和 KPS 90-100（p=0.046）相关。
21-22.5 Gy 的 SRS 剂量比 20 Gy 能更好地控制局部肿瘤。无新脑转移和生存无显著差异。
