Felletti R, Souhami R L, Spiro S G, Geddes D M, Tobias J S, Mantell B S, Harper P G, Trask C
Radiother Oncol. 1985 Dec;4(4):335-9. doi: 10.1016/s0167-8140(85)80121-3.
The time spent in hospital when cerebral metastases occur as the first site of relapse in patients with small cell carcinoma of the lung (SCCL) has been analysed and compared to the consequences of relapse in the liver. In the course of a clinical trial with 370 patients, 50 patients relapsed initially in the brain and 20 in the liver. The 2 groups were comparable with respect to performance status at diagnosis and the amount of home support available. Patients who relapsed in the brain suffered a greater deterioration in performance status, and spent a greater proportion of their remaining life in hospital than did patients whose initial relapse was in the liver. This difference was most marked in patients who died soon after relapse. Radiotherapy (20 Gy in 5 fractions over one week or 30 Gy in 10 fractions over 2 weeks) and dexamethasone were not very effective treatments for brain relapse though subjective responses were common. The substantial morbidity and lengthy hospitalisation resulting from brain relapse compared with relapse at another site is a important factor to be considered in assessing whether prophylactic cranial irradiation should routinely be offered to patients with SCCL.
对小细胞肺癌（SCCL）患者首次复发部位为脑转移时的住院时间进行了分析，并与肝转移复发的情况进行了比较。在一项针对370名患者的临床试验过程中，50名患者最初复发部位为脑，20名患者最初复发部位为肝。两组在诊断时的体能状态以及可获得的家庭支持量方面具有可比性。与最初复发部位为肝的患者相比，复发部位为脑的患者体能状态恶化更严重，在医院度过的余生比例更高。这种差异在复发后不久死亡的患者中最为明显。放疗（一周内分5次给予20 Gy或两周内分10次给予30 Gy）和地塞米松对脑转移复发的治疗效果不太理想，尽管主观反应较为常见。与其他部位复发相比，脑转移复发导致的严重发病率和长时间住院是评估是否应常规对SCCL患者进行预防性颅脑照射时需要考虑的一个重要因素。
