Bagshaw Hilary P, Ly David, Suneja Gita, Jensen Randy L, Shrieve Dennis C
University of Utah Radiation Oncology, 1950 Circle of Hope, Room 1570, Salt Lake City, UT 84112, USA.
University of Utah Neurosurgery, 175 North Medical Drive East, Salt Lake City, UT 84132, USA.
J Radiosurg SBRT. 2016;4(3):181-190.
To examine the effectiveness of stereotactic radiosurgery (SRS) for melanoma brain metastases, as the optimal management is unknown.
Patients with melanoma brain metastases treated between 1999 and 2013 with SRS as initial management were reviewed. Local control (LC), intracranial progression free survival, and overall survival were evaluated using the Kaplan Meier analysis and logistic regression.
185 patients were identified with 435 treated brain metastases. 76% of metastases were controlled, with a median freedom from local failure of 23.4 months. Higher SRS dose (p=0.001) and smaller tumor volume (p=0.0007) were associated with improved LC on univariate analysis, but on multivariate analysis only smaller tumor volume remained significant (p=0.047). At analysis, 7.6% of patients were alive and the median time to death after SRS was 7.8 months.
SRS is an effective primary treatment for melanoma brain metastases. There was no benefit combining SRS and surgery or whole brain radiotherapy.
鉴于最佳治疗方案尚不清楚，研究立体定向放射外科（SRS）治疗黑色素瘤脑转移瘤的有效性。
回顾1999年至2013年间接受SRS作为初始治疗的黑色素瘤脑转移瘤患者。采用Kaplan-Meier分析和逻辑回归评估局部控制（LC）、无颅内进展生存期和总生存期。
共确定185例患者，其脑转移瘤接受了435次治疗。76%的转移瘤得到控制，局部无失败的中位时间为23.4个月。单因素分析显示，较高的SRS剂量（p=0.001）和较小的肿瘤体积（p=0.0007）与改善的LC相关，但多因素分析显示只有较小的肿瘤体积仍具有显著性（p=0.047）。分析时，7.6%的患者存活，SRS后至死亡的中位时间为7.8个月。
SRS是治疗黑色素瘤脑转移瘤的一种有效初始治疗方法。联合SRS与手术或全脑放疗并无益处。
