Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
Anticancer Res. 2020 Jun;40(6):3499-3504. doi: 10.21873/anticanres.14337.
BACKGROUND/AIM: Seizures represent a major problem for patients with brain metastases. This study evaluated the role of seizures in patients receiving single-fraction radiosurgery (SRS) or multi-fraction stereotactic radiotherapy (FSRT).
This retrospective study included 195 patients receiving SRS (n=164) or FSRT (n=31) alone for one to three brain metastases. The prevalence of pre-SRS/FSRT seizures and correlations with pre-treatment factors were investigated. These factors plus pre-SRS/FSRT seizures were assessed in regard to survival.
Thirty-three patients had pre-SRS/FSRT seizures (prevalence=16.9%). Seizures were significantly correlated with age ≤61 years. Trends were observed for seizures being more frequent in those with NSCLC and those without extra-cranial metastatic spread. On multivariate analysis, significant associations with improved survival were found for Karnofsky performance score ≥80%, breast cancer, and an interval from diagnosis of malignant disease to SRS/FSRT ≥21 months.
Younger age, NSCLC and absence of extra-cranial spread appeared to be risk factors for seizures prior to SRS/FSRT. Having seizures prior to SRS/FSRT showed no association with survival.
背景/目的：癫痫发作是脑转移瘤患者的主要问题。本研究评估了单次分割放射外科手术（SRS）或多分割立体定向放射治疗（FSRT）治疗患者中癫痫发作的作用。
本回顾性研究纳入了 195 名接受单一至三个脑转移灶 SRS（n=164）或 FSRT（n=31）治疗的患者。研究了治疗前癫痫发作的发生率及其与治疗前因素的相关性。这些因素以及治疗前癫痫发作与生存情况进行了评估。
33 名患者在 SRS/FSRT 治疗前有癫痫发作（发生率为 16.9%）。癫痫发作与年龄≤61 岁显著相关。有趋势表明，非小细胞肺癌和无颅外转移的患者癫痫发作更为频繁。多因素分析显示，Karnofsky 表现评分≥80%、乳腺癌和恶性疾病诊断至 SRS/FSRT 的时间间隔≥21 个月与生存改善显著相关。
SRS/FSRT 治疗前年龄较小、非小细胞肺癌和无颅外转移似乎是癫痫发作的危险因素。SRS/FSRT 治疗前癫痫发作与生存无关。
