Cordeiro Diogo, Xu Zhiyuan, Shepard Matthew, Sheehan Darrah, Li Chelsea, Sheehan Jason
Department of Neurological Surgery, University of Virginia Charlottesville, VA, USA.
J Radiosurg SBRT. 2019;6(1):35-43.
In the present study, we reviewed the efficacy of stereotactic radiosurgery (SRS) alone or in combination with WBRT, for the treatment of patients with BM secondary to SCLC. We further identified patient and treatment specific factors that correlated with improved survival.
Forty-one patients treated with GKRS for BM secondary to SCLC from 2004 to 2017 at the University of Virginia were identified with histopathologically proven SCLC and included in the study.
Following the first GKRS treatment, the median survival was 6 months (1-41 months). There was no statistical difference in overall survival and tumor control between the patients who had PCI, WBRT or upfront GKRS. The only factor associated with decreased OS after the diagnosis of BM from SCLC was active extracranial disease (P=0.045, HR=2.354).
Stereotactic radiosurgery is a reasonable treatment option for patients with brain metastases of SCLC who had PCI or WBRT failure.
在本研究中，我们回顾了立体定向放射外科（SRS）单独或联合全脑放疗（WBRT）治疗小细胞肺癌（SCLC）脑转移患者的疗效。我们进一步确定了与生存期改善相关的患者和治疗特定因素。
确定了2004年至2017年在弗吉尼亚大学接受伽玛刀放射外科（GKRS）治疗SCLC脑转移的41例患者，这些患者经组织病理学证实为SCLC并纳入研究。
首次GKRS治疗后，中位生存期为6个月（1 - 41个月）。接受全脑照射（PCI）、全脑放疗（WBRT）或先行GKRS治疗的患者在总生存期和肿瘤控制方面无统计学差异。SCLC脑转移诊断后与总生存期降低相关的唯一因素是存在颅外活动性疾病（P = 0.045，风险比[HR]=2.354）。
对于接受过PCI或WBRT治疗失败的SCLC脑转移患者，立体定向放射外科是一种合理的治疗选择。
