老年人脑转移行立体定向放射外科（SRS）或分次立体定向放疗（FSRT）后的生存情况。
Survival After Stereotactic Radiosurgery (SRS) or Fractionated Stereotactic Radiotherapy (FSRT) for Cerebral Metastases in the Elderly.
机构信息
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
出版信息
In Vivo. 2020 Jul-Aug;34(4):1909-1913. doi: 10.21873/invivo.11987.
BACKGROUND/AIM: Stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) have gained popularity especially for treating 1-3 cerebral metastases. Elderly patients benefit from treatment personalisation. A specific survival score was created to facilitate this approach.
PATIENTS AND METHODS
Ten characteristics were retrospectively analysed for survival in 104 elderly patients with 1-3 cerebral metastases receiving SRS or FSRT alone using a linear accelerator or Cyberknife®.
RESULTS
On multivariate analysis, better survival was significantly associated with KPS of 90-100 (p=0.049), single lesion (p=0.036), maximum cumulative diameter of all lesions <16 mm (p=0.026) and supratentorial involvement only (p=0.047). Three groups were formed with 12-14 points (n=22), 15-16 points (n=33) and 17-19 points (n=49) with 12-month survival rates of 7%, 34% and 58% (p<0.0001), respectively. Positive predictive values for predicting death ≤12 months and survival ≥12 months were 95% and 54%.
CONCLUSION
The new score showed very high accuracy in predicting death ≤12 months, but not in predicting survival ≥12 months.
背景/目的：立体定向放射外科（SRS）和分次立体定向放射治疗（FSRT）越来越受欢迎，尤其适用于治疗 1-3 个脑转移瘤。老年患者从治疗个体化中受益。创建了一个特定的生存评分来促进这种方法。
患者和方法
对 104 名接受 SRS 或 FSRT 治疗的 1-3 个脑转移瘤的老年患者（单独使用直线加速器或 Cyberknife®）的 10 个特征进行回顾性分析，以评估其生存情况。
结果
多变量分析显示，更好的生存与 KPS 为 90-100（p=0.049）、单发病变（p=0.036）、所有病变的最大累积直径<16mm（p=0.026）和仅幕上受累（p=0.047）显著相关。将患者分为 3 组，每组 12-14 分（n=22）、15-16 分（n=33）和 17-19 分（n=49），12 个月生存率分别为 7%、34%和 58%（p<0.0001）。预测死亡≤12 个月和生存≥12 个月的阳性预测值分别为 95%和 54%。
结论
新评分在预测死亡≤12 个月方面具有很高的准确性，但在预测生存≥12 个月方面准确性较低。
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