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乳腺癌脑转移瘤的放射治疗:治疗结果及预后因素

Radiotherapy of brain metastases from breast cancer: Treatment results and prognostic factors.

作者信息

Kühnöl Julia, Kühnöl Caspar, Vordermark Dirk

机构信息

Department of Radiation Oncology, Martin Luther University Halle-Wittenberg, D-06120 Halle (Saale), Saxony-Anhalt, Germany.

Department of Paediatrics, Martin Luther University Halle-Wittenberg, D-06120 Halle (Saale), Saxony-Anhalt, Germany.

出版信息

Oncol Lett. 2016 May;11(5):3223-3227. doi: 10.3892/ol.2016.4349. Epub 2016 Mar 17.

Abstract

Brain metastases (BM) from breast cancer are associated with high morbidity and a poor prognosis. The aim of this study was to analyse the role of radiotherapy in treatment of BM from breast cancer in the context of modern local therapy modalities, current systemic treatment options and prognostic factors. A retrospective analysis of 86 consecutive female patients treated with radiotherapy for BM from breast cancer between 2000 and 2010 was conducted. Patient and treatment characteristics were registered and survival data calculated. All patients received whole-brain radiotherapy (WBRT) with a median dose of 36 Gy, and 19 patients were treated with an additional boost; this included fractionated schemes (median dose, 18 Gy) and radiosurgery (5 and 17 Gy). The median overall survival time from the start of WBRT was 4.1 months in the present cohort. Patients receiving a boost survived 19.7 months in comparison to 3.1 months for patients treated with WBRT alone (P<0.001). Other factors that improved overall survival, based on a univariate analysis, were dose of WBRT and number of BM. There was no statistical evidence for the influence of the human epidermal growth factor receptor 2 status on survival in the current study. The administration of boost treatment following WBRT was also identified as a significant factor influencing survival on multivariate analysis (P=0.030). In conclusion, radiotherapy affects the survival time of patients with BM from breast cancer. In particular, the implementation of boost treatment following WBRT in selected patients seems to extend survival time.

摘要

乳腺癌脑转移(BM)与高发病率和不良预后相关。本研究的目的是在现代局部治疗方式、当前全身治疗选择和预后因素的背景下,分析放射治疗在乳腺癌脑转移治疗中的作用。对2000年至2010年间连续86例接受乳腺癌脑转移放射治疗的女性患者进行了回顾性分析。记录患者和治疗特征并计算生存数据。所有患者均接受全脑放疗(WBRT),中位剂量为36 Gy,19例患者接受了额外的推量照射;这包括分次照射方案(中位剂量,18 Gy)和立体定向放射外科治疗(5和17 Gy)。在本队列中,从开始WBRT起的中位总生存时间为4.1个月。接受推量照射的患者生存19.7个月,而仅接受WBRT治疗的患者为3.1个月(P<0.001)。基于单因素分析,其他改善总生存的因素是WBRT剂量和脑转移灶数量。在本研究中,没有统计学证据表明人表皮生长因子受体2状态对生存有影响。在多因素分析中,WBRT后给予推量治疗也被确定为影响生存的一个重要因素(P = 0.030)。总之,放射治疗影响乳腺癌脑转移患者的生存时间。特别是,在选定患者中WBRT后实施推量治疗似乎可延长生存时间。

相似文献

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Whole brain radiotherapy for the treatment of multiple brain metastases.全脑放疗用于治疗多发性脑转移瘤。
Cochrane Database Syst Rev. 2006 Jul 19(3):CD003869. doi: 10.1002/14651858.CD003869.pub2.

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