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小细胞肺癌脑转移患者的立体定向分割放疗

Fractionated stereotactic radiotherapy for small-cell lung cancer patients with brain metastases.

作者信息

Li Xiang-Pan, Xiao Jian-Ping, Chen Xiu-Jun, Jiang Xue-Song, Zhang Ye, Xu Ying-Jie

机构信息

Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

J Cancer Res Ther. 2014 Jul-Sep;10(3):597-602. doi: 10.4103/0973-1482.137964.

Abstract

OBJECTIVE

Patients with small-cell lung cancer (SCLC) are at high risk of developing brain metastases (BM). Fractionated stereotactic radiotherapy (FSRT) alone or combined with whole brain radiation therapy can be used to treat intracranial metastases. This study was aimed to explore FSRT for BM from SCLC.

MATERIALS AND METHODS

We retrospectively analyzed 45 patients with BM from SCLC treated with fractionated linear accelerator FSRT. Multivariate analysis was used to determine independent risk factors of overall survival (OS).

RESULTS

There were 35 patients treated with salvage FSRT and 10 patients treated with primary FSRT. The median OS was 10 months from the beginning of FSRT and 19 months from diagnosis of BM. The median OS of salvage FSRT group and primary FSRT group was 22 and 10 months from the diagnosis of BM, respectively (P = 0.011); 11 and 8 months from FSRT, respectively (P = 0.828). Recursive partitioning analysis class and the stage of the primary tumor were independent predictors of increased OS (relative risk [RR] = 2.634, P = 0.021 and RR = 2.324, P = 0.0210, respectively).

CONCLUSIONS

Salvage and primary FSRT were both effective treatment options for BM from SCLC. Salvage and primary FSRT may have different OS from the time of diagnosis of BM.

摘要

目的

小细胞肺癌(SCLC)患者发生脑转移(BM)的风险很高。单纯分次立体定向放射治疗(FSRT)或联合全脑放射治疗可用于治疗颅内转移瘤。本研究旨在探讨FSRT治疗SCLC脑转移的疗效。

材料与方法

我们回顾性分析了45例接受分次直线加速器FSRT治疗的SCLC脑转移患者。采用多因素分析确定总生存期(OS)的独立危险因素。

结果

35例患者接受挽救性FSRT治疗,10例患者接受原发性FSRT治疗。从FSRT开始计算,中位OS为10个月;从BM诊断开始计算,中位OS为19个月。挽救性FSRT组和原发性FSRT组从BM诊断开始的中位OS分别为22个月和10个月(P = 0.011);从FSRT开始分别为11个月和8个月(P = 0.828)。递归分割分析类别和原发肿瘤分期是OS增加的独立预测因素(相对风险[RR]分别为2.634,P = 0.021和RR = 2.324,P = 0.0210)。

结论

挽救性和原发性FSRT都是治疗SCLC脑转移的有效选择。挽救性和原发性FSRT从BM诊断时起可能有不同的OS。

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