Lam Tai-Chung, Sahgal Arjun, Lo Simon S, Chang Eric L
Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Hong Kong SAR, China.
Department of Radiation Oncology, Sunnybrook Health Science Centre, University of Toronto, Toronto, ON, Canada.
Chin Clin Oncol. 2017 Aug;6(4):35. doi: 10.21037/cco.2017.06.02.
Radiation therapy (RT) is an important treatment modality for brain metastases. Recent clinical trials have established the role of stereotactic radiosurgery (SRS) in the improvement of local control of brain metastases. Prospective trial data confirmed the feasibility and efficacy of using SRS alone to treat 5 or more brain metastatic tumors. Besides tumor control, there is increased emphasis on quality of life and neurocognitive function preservation. The new approach of hippocampi-sparing whole brain RT has been tested in an attempt to minimize the neurocognitive toxicity of whole brain RT. There is now level 1 evidence to support the multidisciplinary approach of surgical resection of brain metastases followed by cavity SRS which has been shown to preserve neurocognitive function without compromising survival. The current review summarizes the recent advances in RT for brain metastases.
放射治疗（RT）是脑转移瘤的重要治疗方式。近期临床试验确立了立体定向放射外科（SRS）在改善脑转移瘤局部控制方面的作用。前瞻性试验数据证实了单独使用SRS治疗5个或更多脑转移瘤的可行性和有效性。除了肿瘤控制外，人们越来越重视生活质量和神经认知功能的保留。海马体保留全脑放疗的新方法已得到测试，旨在尽量减少全脑放疗的神经认知毒性。现在有一级证据支持脑转移瘤手术切除后行瘤腔SRS的多学科方法，该方法已被证明可保留神经认知功能且不影响生存率。本综述总结了脑转移瘤放射治疗的最新进展。
