Rades Dirk, Dziggel Liesa, Janssen Stefan, Khoa Mai Trong, Duong Vuong Ngoc, Khiem Vu Huu, Gebauer Niklas, Bartscht Tobias, Schild Steven E
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
Faculty of Medicine, Hanoi Medical University, Hanoi, Vietnam.
Anticancer Res. 2018 Apr;38(4):2415-2418. doi: 10.21873/anticanres.12492.
BACKGROUND/AIM: To identify predictors of local control and survival after whole-brain irradiation (WBI) for cerebral metastases from cancer of unknown primary (CUP).
In 140 patients receiving WBI alone or following resection, seven factors were investigated including treatment approach, WBI-regimen, age, gender, Eastern Cooperative Oncology Group (ECOG) performance score, number of cerebral lesions and extra-cerebral metastases.
On univariate analysis, resection plus WBI and boost (p=0.002), ECOG 0-1 (p<0.001) and a single lesion (p<0.001) were positively associated with local control. On Cox regression, ECOG-score remained significant (p=0.002). On univariate analysis of survival, surgery plus WBI and boost (p=0.009), ECOG 0-1 (p<0.001), a single lesion (p=0.024) and no extra-cerebral metastases (p<0.001) were associated with better outcomes. On Cox regression, ECOG-score (p<0.001) and extra-cerebral lesions (p<0.001) were significant.
Significant predictors of local control and survival were identified that contribute to treatment personalization and design of prospective trials in patients with cerebral metastases from CUP.
背景/目的：确定未知原发癌（CUP）脑转移患者全脑照射（WBI）后局部控制和生存的预测因素。
对140例单独接受WBI或术后接受WBI的患者，研究了七个因素，包括治疗方法、WBI方案、年龄、性别、东部肿瘤协作组（ECOG）体能状态评分、脑转移瘤数量和脑外转移情况。
单因素分析显示，手术加WBI及追加剂量照射（p = 0.002）、ECOG 0 - 1（p < 0.001）和单个转移瘤（p < 0.001）与局部控制呈正相关。Cox回归分析显示，ECOG评分仍具有显著性（p = 0.002）。生存单因素分析显示，手术加WBI及追加剂量照射（p = 0.009）、ECOG 0 - 1（p < 0.001）、单个转移瘤（p = 0.024）和无脑外转移（p < 0.001）与较好的预后相关。Cox回归分析显示，ECOG评分（p < 0.001）和脑外转移灶（p < 0.001）具有显著性。
确定了局部控制和生存的显著预测因素，有助于CUP脑转移患者的治疗个体化和前瞻性试验设计。
