Miccio Joseph A, Barsky Andrew, Gao Sarah, Verma Vivek, Noticewala Sonal S, Jairam Vikram, Johnson Skyler B, Yu James B, Hansen James E, Aneja Sanjay, An Yi, Decker Roy H, Bulent Omay S, Li Jing, Kurtz Goldie A, Alonso-Basanta Michelle, Lee John Y K, Chiang Veronica L, Park Henry S
Department of Therapeutic Radiology, Yale School of Medicine, New Haven, CT 06511, USA.
Department of Radiation Oncology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA.
J Radiosurg SBRT. 2020;7(1):19-27.
Patients with small cell lung cancer (SCLC) brain metastasis (BM) typically receive whole brain radiotherapy (WBRT) as data regarding upfront radiosurgery (SRS) in this setting are sparse. Patients receiving SRS for SCLC BM without prior brain radiation were identified at three U.S. institutions. Overall survival (OS), freedom from intracranial progression (FFIP), freedom from WBRT (FFWBRT), and freedom from neurologic death (FFND) were determined from time of SRS. Thirty-three patients were included with a median of 2 BM (IQR 1-6). Median OS and FFIP were 6.7 and 5.8 months, respectively. Median FFIP for patients with ≤2 versus >2 BM was 7.1 versus 3.6 months, p=0.0303. Eight patients received salvage WBRT and the 6-month FFWBRT and FFND were 87.8%. and 90.1%, respectively. Most SCLC patients with BM who received upfront SRS avoided WBRT and neurologic death, suggesting that SRS may be an option in select patients.
小细胞肺癌（SCLC）脑转移（BM）患者通常接受全脑放疗（WBRT），因为在这种情况下关于 upfront 立体定向放射外科治疗（SRS）的数据很少。在美国的三个机构中确定了未接受过脑部放疗而接受 SRS 治疗 SCLC BM 的患者。从 SRS 时间开始确定总生存期（OS）、无颅内进展生存期（FFIP）、无 WBRT 生存期（FFWBRT）和无神经学死亡生存期（FFND）。纳入了 33 例患者，BM 的中位数为 2（四分位间距 1 - 6）。中位 OS 和 FFIP 分别为 6.7 个月和 5.8 个月。BM≤2 与＞2 的患者的中位 FFIP 分别为 7.1 个月和 3.6 个月，p = 0.0303。8 例患者接受了挽救性 WBRT，6 个月时的 FFWBRT 和 FFND 分别为 87.8%和 90.1%。大多数接受 upfront SRS 的 SCLC BM 患者避免了 WBRT 和神经学死亡，这表明 SRS 可能是部分患者的一种选择。
