Gigliotti Michael J, Hasan Shaakir, Fuhrer Russell, Krivak Thomas, Aziz Khaled, Wegner Rodney E
Allegheny Health Network Cancer Institute, Division of Radiation Oncology, 320 East North Ave, Pittsburgh, PA 15212, USA.
Allegheny Health Network, Division of Gynecologic Oncology, 320 East North Ave, Pittsburgh, PA 15212, USA.
Gynecol Oncol Rep. 2018 May 17;25:19-23. doi: 10.1016/j.gore.2018.05.007. eCollection 2018 Aug.
The use of SRS and fSRT to determine overall survival, tumor control, and local-disease free progression in patient diagnosed with gynecologic brain metastasis.
In this retrospective review, 11 patients aged 50 to 85 (median age of 71) were treated with linear accelerator-based SRS and hypofractionated SRT for brain metastasis secondary to gynecologic malignancies. In total, 16 tumors were treated from 2007 to 2017. Patients were treated to a median dose of 24 Gy (range 15 to 30 Gy) in 3 Fx (range 1 to 5). Median follow-up from SRS or SRT was 4 months (range 3-38 months).
The actuarial 1-year overall survival rate was 26% with a median overall survival of 8 months. In addition, 1-year actuarial local control rate was 83.3% and the 1-year distant brain control rate was 31%. One patient experienced toxicity that presented as seizures after 7 months (due to minimal edema) that required anticonvulsants. There was no other acute or late treatment-related toxicity. Linear-accelerator based SRS or fSRT is safe and effective for control of local tumor growth in brain metastases secondary to gynecologic malignancies. The course of disease remains aggressive as seen by poor overall survival and distant failure rate.
使用立体定向放射外科（SRS）和分次立体定向放射治疗（fSRT）来确定诊断为妇科脑转移患者的总生存期、肿瘤控制情况及局部无病进展情况。
在这项回顾性研究中，11名年龄在50至85岁（中位年龄71岁）的患者接受了基于直线加速器的SRS和超分割SRT治疗继发于妇科恶性肿瘤的脑转移。2007年至2017年共治疗了16个肿瘤。患者接受的中位剂量为24 Gy（范围15至30 Gy），分3次照射（范围1至5次）。SRS或SRT后的中位随访时间为4个月（范围3至38个月）。
精算1年总生存率为26%，中位总生存期为8个月。此外，1年精算局部控制率为83.3%，1年远处脑控制率为31%。1例患者在7个月后出现毒性反应，表现为癫痫发作（由于轻度水肿），需要使用抗惊厥药物。没有其他急性或晚期治疗相关毒性。基于直线加速器的SRS或fSRT对于控制继发于妇科恶性肿瘤的脑转移瘤的局部肿瘤生长是安全有效的。从较差的总生存期和远处失败率可以看出，疾病进程仍然具有侵袭性。
