预测老年患者立体定向放射外科或分次立体定向放射治疗后远处脑转移的风险。

Predicting the Risk of Subsequent Distant Brain Metastases After Stereotactic Radiosurgery or Fractionated Stereotactic Radiotherapy in Elderly Patients.

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

Anticancer Res. 2020 Jul;40(7):4081-4086. doi: 10.21873/anticanres.14406.

DOI:10.21873/anticanres.14406

PMID:32620656

Abstract

BACKGROUND/AIM: Treatment for elderly patients with few brain metastases is controversial. A score was generated to predict distant brain metastases (DBMs) after stereotactic radiosurgery (SRS) or fractionated stereotactic radiotherapy (FSRT).

PATIENTS AND METHODS

Ten characteristics were retrospectively analyzed for freedom from new DBMs in 104 elderly patients receiving SRS or FSRT alone for 1-3 brain metastases. Characteristics that were significant or showed a trend on multivariate analysis were used for the score.

RESULTS

On multivariate analysis, favorable histology (p=0.026) and single brain metastasis (p=0.006) showed significant associations with freedom from DBMs. A trend was found for supra-tentorial location only (p=0.065). Three groups were designed, 10-14, 16-20 and 21-25 points, with 6-month rates of freedom from DBMs of 10%, 54% and 95%, respectively (p<0.0001). Positive predictive values to predict DBMs and freedom from DBMs at 6 months were 91% and 94%.

CONCLUSION

This new score provided high accuracy in predicting DBMs and freedom from DBMs.

摘要

背景/目的：对于仅有少量脑转移的老年患者的治疗存在争议。我们生成了一个评分系统，用于预测立体定向放射外科（SRS）或分次立体定向放射治疗（FSRT）后远处脑转移（DBMs）的发生。

患者与方法

对 104 例接受 SRS 或 FSRT 单独治疗 1-3 个脑转移灶的老年患者的 10 个特征进行回顾性分析，以评估 SRS 或 FSRT 后无新发 DBM 的无进展生存期。多变量分析中具有显著意义或趋势的特征被用于该评分系统。

结果

多变量分析显示，良好的组织学（p=0.026）和单发脑转移（p=0.006）与无 DBM 生存时间显著相关。仅幕上位置有趋势（p=0.065）。将患者分为 10-14 分、16-20 分和 21-25 分 3 组，6 个月无 DBM 生存率分别为 10%、54%和 95%（p<0.0001）。预测 DBM 发生和 6 个月无 DBM 生存的阳性预测值分别为 91%和 94%。