文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

采用非共面单等中心(HyperArc™)技术的重复立体定向放射外科(SRS)与 upfront 全脑放疗(WBRT)的比较:一项配对分析。

Repeated stereotactic radiosurgery (SRS) using a non-coplanar mono-isocenter (HyperArc™) technique versus upfront whole-brain radiotherapy (WBRT): a matched-pair analysis.

机构信息

Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034, Negrar, Verona, Italy.

Medical Analysis Laboratory, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Negrar, Italy.

出版信息

Clin Exp Metastasis. 2020 Feb;37(1):77-83. doi: 10.1007/s10585-019-10004-3. Epub 2019 Nov 6.


DOI:10.1007/s10585-019-10004-3
PMID:31691873
Abstract

Stereotactic radiosurgery (SRS) is an effective treatment option for multiple brain metastases (BMs). Modern mono-isocentric techniques allow the delivery of multiple stereotactic courses, in the event of intracranial failure. Nevertheless, limited data on effectiveness and toxicity have been reported in comparison to WBRT. Aim of this retrospective matched-pair analysis was to compare patients affected by limited BMs treated with multiple SRS courses using a mono-isocentric, non-coplanar technique (HyperArc™, Varian Medical System) to upfront WBRT. One hundred and two patients accounting for 677 BMs were treated with HyperArc™. In case of further intracranial progression, 44 treatment courses of 201 metastases in 19 patients, were treated by subsequent HyperArc™ courses. This population was matched with 38 patients treated with WBRT. The median BMs number was 4 (range 2-10) for HyperArc™ and 5 (range 2-10) for WBRT. Overall survival (OS) and toxicity were evaluated. The median follow-up was 9 months (range 3-40 months). The median OS was not reached (range 5-22 months) for HyperArc™ patients and 8 months (range 3-40 months) for WBRT patients, while the 1-year OS was 77% and 34.6% for HyperArc™ and WBRT, respectively (p = 0.001; HR 4.77, 95% CI 1.62-14.00). There was one case of radionecrosis. HyperArc™ is an effective and safe technique for the treatment of multiple BMs. In selected cases of intracranial oligorecurrence, further subsequent courses can be safely delivered with the same technical approach. Moreover, in patients with a limited number of BMs, SRS showed an improved survival outcome when compared to WBRT.

摘要

立体定向放射外科(SRS)是治疗多发性脑转移瘤(BMs)的有效治疗选择。现代单等中心技术允许在颅内失败的情况下提供多次立体定向治疗。然而,与 WBRT 相比,其有效性和毒性的数据有限。本回顾性配对分析的目的是比较使用单等中心、非共面技术(Varian Medical System 的 HyperArc™)治疗局限性 BMs 的患者,这些患者接受了多次 SRS 治疗,而不是采用 WBRT。102 名患者(677 个 BM)接受了 HyperArc™治疗。如果颅内进一步进展,19 名患者中有 201 个转移灶的 44 个治疗疗程随后接受了 HyperArc™治疗。该人群与 38 名接受 WBRT 治疗的患者相匹配。HyperArc™的 BM 中位数为 4(范围 2-10),WBRT 的 BM 中位数为 5(范围 2-10)。评估了总生存期(OS)和毒性。中位随访时间为 9 个月(范围 3-40 个月)。HyperArc™患者的中位 OS 未达到(范围 5-22 个月),WBRT 患者为 8 个月(范围 3-40 个月),1 年 OS 分别为 HyperArc™和 WBRT 的 77%和 34.6%(p=0.001;HR 4.77,95%CI 1.62-14.00)。有 1 例放射性坏死。HyperArc™是治疗多发性 BMs 的有效且安全的技术。在颅内寡复发的情况下,可使用相同的技术方法安全地提供进一步的后续治疗。此外,对于 BM 数量有限的患者,与 WBRT 相比,SRS 显示出更好的生存结果。

相似文献

[1]
Repeated stereotactic radiosurgery (SRS) using a non-coplanar mono-isocenter (HyperArc™) technique versus upfront whole-brain radiotherapy (WBRT): a matched-pair analysis.

Clin Exp Metastasis. 2019-11-6

[2]
Long-term disease outcome and volume-based decision strategy in a large cohort of multiple brain metastases treated with a mono-isocentric linac-based Stereotactic Radiosurgery technique.

Clin Transl Oncol. 2021-8

[3]
First experience and clinical results using a new non-coplanar mono-isocenter technique (HyperArc™) for Linac-based VMAT radiosurgery in brain metastases.

J Cancer Res Clin Oncol. 2018-10-31

[4]
Potential role for LINAC-based stereotactic radiosurgery for the treatment of 5 or more radioresistant melanoma brain metastases.

J Neurosurg. 2015-11

[5]
Intracranial control and radiographic changes with adjuvant radiation therapy for resected brain metastases: whole brain radiotherapy versus stereotactic radiosurgery alone.

J Neurooncol. 2014-12

[6]
Use of Stereotactic Radiosurgery in Elderly and Very Elderly Patients With Brain Metastases to Limit Toxicity Associated With Whole Brain Radiation Therapy.

Int J Radiat Oncol Biol Phys. 2017-2-21

[7]
Repeat stereotactic radiosurgery as salvage therapy for locally recurrent brain metastases previously treated with radiosurgery.

J Neurosurg. 2016-8-5

[8]
Repeated in-field radiosurgery for locally recurrent brain metastases: Feasibility, results and survival in a heavily treated patient cohort.

PLoS One. 2018-6-6

[9]
A matched-pair analysis comparing stereotactic radiosurgery with whole-brain radiotherapy for patients with multiple brain metastases.

J Neurooncol. 2020-5

[10]
Clinical outcomes of gastrointestinal brain metastases treated with radiotherapy.

Radiat Oncol. 2017-2-28

引用本文的文献

[1]
A Time-Series Approach for Machine Learning-Based Patient-Specific Quality Assurance of Radiosurgery Plans.

Bioengineering (Basel). 2025-8-21

[2]
Repeat stereotactic radiosurgery for recurrent brain metastases: a retrospective comparison of local progression and distant brain metastases after prior radiosurgery.

J Neurooncol. 2025-4-9

[3]
A Dosimetric Comparison of HyperArc Therapy Planning and Volumetric Modulated Arc Therapy Planning in Treating Patients With Glioblastoma Multiforme.

In Vivo. 2025

[4]
Multidisciplinary management strategies for recurrent brain metastasis after prior radiotherapy: An overview.

Neuro Oncol. 2025-3-7

[5]
Optimization of sub-arc collimator angles in volumetric modulated arc therapy: a heatmap-based blocking index approach for multiple brain metastases.

Phys Eng Sci Med. 2024-12

[6]
Outcome of whole brain irradiation with a dose-escalated simultaneous-integrated boost in patients with multiple large and/or diffuse brain metastases: real live data and review of the literature.

Discov Oncol. 2024-8-7

[7]
Repeated HyperArc radiosurgery for recurrent intracranial metastases and dosimetric analysis of recurrence pattern to account for diffuse dose effect on microscopical disease.

Clin Transl Radiat Oncol. 2024-6-24

[8]
HyperArcTM volumetric modulated arc therapy for hypopharyngeal cancer with solitary recurrence in the cervical vertebra: A case report and literature review.

Medicine (Baltimore). 2024-6-7

[9]
Dose-Painting Linear Accelerator Radiosurgery of Glomus Jugulare With Dosimetric Comparison to Gamma Knife.

Cureus. 2024-2-27

[10]
Automatically tracking brain metastases after stereotactic radiosurgery.

Phys Imaging Radiat Oncol. 2023-6-1

本文引用的文献

[1]
The Efficacy of Upfront Intracranial Radiation with TKI Compared to TKI Alone in the NSCLC Patients Harboring EGFR Mutation and Brain Metastases.

J Cancer. 2019-5-12

[2]
Single isocenter stereotactic radiosurgery for patients with multiple brain metastases: dosimetric comparison of VMAT and a dedicated DCAT planning tool.

Radiat Oncol. 2019-6-11

[3]
Role of Radiosurgery/Stereotactic Radiotherapy in Oligometastatic Disease: Brain Oligometastases.

Front Oncol. 2019-4-4

[4]
Stereotactic radiosurgery combined with nivolumab or Ipilimumab for patients with melanoma brain metastases: evaluation of brain control and toxicity.

J Immunother Cancer. 2019-4-11

[5]
Linac-based radiosurgery for multiple brain metastases: Comparison between two mono-isocenter techniques with multiple non-coplanar arcs.

Radiother Oncol. 2018-12-21

[6]
Repeated Courses of Radiosurgery for New Brain Metastases to Defer Whole Brain Radiotherapy: Feasibility and Outcome With Validation of the New Prognostic Metric Brain Metastasis Velocity.

Front Oncol. 2018-11-22

[7]
Validity of a Recently Proposed Prognostic Grading Index, Brain Metastasis Velocity, for Patients With Brain Metastasis Undergoing Multiple Radiosurgical Procedures.

Int J Radiat Oncol Biol Phys. 2018-11-3

[8]
Single versus Multifraction Stereotactic Radiosurgery for Large Brain Metastases: An International Meta-analysis of 24 Trials.

Int J Radiat Oncol Biol Phys. 2018-11-2

[9]
First experience and clinical results using a new non-coplanar mono-isocenter technique (HyperArc™) for Linac-based VMAT radiosurgery in brain metastases.

J Cancer Res Clin Oncol. 2018-10-31

[10]
Clinical Outcomes of Upfront Stereotactic Radiosurgery Alone for Patients With 5 to 15 Brain Metastases.

Neurosurgery. 2019-8-1

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索