Maranzano Ernesto, Casale Michelina, Rispoli Rossella, Trippa Fabio, Draghini Lorena, Arcidiacono Fabio, Carletti Sandro, Anselmo Paola
Radiotherapy Oncology Center, S. Maria Hospital, Terni, Italy -
Radiotherapy Oncology Center, S. Maria Hospital, Terni, Italy.
J Neurosurg Sci. 2020 Feb;64(1):37-43. doi: 10.23736/S0390-5616.16.03745-0. Epub 2016 Sep 7.
BACKGROUND: The aim of this study was to report response, overall survival (OS) and toxicity in patients with radioresistant brain metastases (BM) treated with stereotactic radiosurgery (SRS). METHODS: Patients with renal cell carcinoma, melanoma and sarcoma with one to four brain metastases received SRS without whole brain radiotherapy. RESULTS: Fifty patients with 77 BM were treated. 46 (92%) patients with 71 BM were evaluable. Median follow-up was 67 months and median OS 11.8 months. At the time of analysis all patients had died. Brain control was conditioned by response to SRS (P<0.0001), while OS by histology (renal cell carcinoma versus melanoma and sarcoma) (P=0.04) and status of the tumour outside the brain (P=0.05). Treatment was well tolerated without more than grade 2 acute toxicity. CONCLUSIONS: Treatment of BM from radioresistant tumors with SRS assures good brain control and OS with low toxicity. Our data suggest a better prognosis associated to renal cell carcinoma histology.
背景：本研究旨在报告接受立体定向放射外科治疗（SRS）的放射性抵抗性脑转移瘤（BM）患者的反应、总生存期（OS）和毒性。 方法：患有肾细胞癌、黑色素瘤和肉瘤且有一至四处脑转移的患者接受了SRS治疗，未进行全脑放疗。 结果：共治疗了50例患者的77处BM。46例（92%）患者的71处BM可评估。中位随访时间为67个月，中位总生存期为11.8个月。在分析时，所有患者均已死亡。脑控制情况取决于对SRS的反应（P<0.0001），而总生存期则取决于组织学类型（肾细胞癌与黑色素瘤和肉瘤）（P=0.04）以及脑外肿瘤状态（P=0.05）。治疗耐受性良好，急性毒性不超过2级。 结论：用SRS治疗放射性抵抗性肿瘤的脑转移瘤可确保良好的脑控制和总生存期，且毒性较低。我们的数据表明肾细胞癌组织学类型的预后较好。
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