Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Anticancer Res. 2020 May;40(5):2841-2845. doi: 10.21873/anticanres.14258.
BACKGROUND/AIM: Although omitting whole-brain radiotherapy (WBRT) during the treatment of few brain metastases more popular, many patients receive local therapies plus WBRT. WBRT may be less reasonable for patients with poor overall survival (OS), particularly if they are older. This study aimed to identify predictors of OS in these patients.
One-hundred-and-two older patients receiving a local therapy (surgery, radiosurgery, simultaneous integrated boost) and WBRT for 1-3 brain metastases were evaluated. Type of local therapy, WBRT-regimen, age, gender, performance status, primary tumour type, number of brain metastases, extra-cerebral metastasis, and interval from tumour diagnosis to treatment of brain metastases were analysed for OS.
Absence of extra-cerebral metastasis was significantly associated with increased OS on univariate analysis (p=0.001) and Cox regression analysis (risk ratio=2.13, p=0.002).
Extra-cerebral metastasis is an independent predictor of OS and can be helpful when assigning a treatment to older patients with few brain metastases.
背景/目的:虽然在治疗少量脑转移瘤时省略全脑放疗(WBRT)越来越受欢迎,但许多患者仍接受局部治疗加 WBRT。对于总生存(OS)较差的患者,尤其是年龄较大的患者,WBRT 可能不太合理。本研究旨在确定这些患者 OS 的预测因素。
对 102 名接受局部治疗(手术、放射外科、同时整合增强)和 WBRT 治疗 1-3 个脑转移瘤的老年患者进行评估。分析局部治疗类型、WBRT 方案、年龄、性别、体力状况、原发肿瘤类型、脑转移瘤数量、颅外转移和从肿瘤诊断到脑转移治疗的时间间隔与 OS 的关系。
在单因素分析(p=0.001)和 Cox 回归分析(风险比=2.13,p=0.002)中,无颅外转移与 OS 延长显著相关。
颅外转移是 OS 的独立预测因素,对于为少量脑转移瘤的老年患者分配治疗方案时可能会有所帮助。