Ehret Felix, Senger Carolin, Kufeld Markus, Fürweger Christoph, Kord Melina, Haidenberger Alfred, Windisch Paul, Rueß Daniel, Kaul David, Ruge Maximilian, Schichor Christian, Tonn Jörg-Christian, Muacevic Alexander
Department of Radiation Oncology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany.
European Cyberknife Center, 81377 Munich, Germany.
Cancers (Basel). 2021 Jan 15;13(2):297. doi: 10.3390/cancers13020297.
Intramedullary metastases are rare and bear a dismal prognosis. Limited data are available on the treatment of such lesions. As surgery may be the mainstay of treatment for patients with resectable and localized metastatic spread, previous case reports and case series suggest radiosurgery to be another viable treatment modality. This multicenter study analyzes the efficacy and safety of robotic radiosurgery (RRS) for intramedullary metastases.
Patients who received RRS for the treatment of at least one intramedullary metastasis were included.
Thirty-three patients with 46 intramedullary metastases were treated with a median dose of 16 Gy prescribed to a median isodose of 70%. The local control was 79% after a median follow-up of 8.5 months. The median overall survival (OS) was 11.7 months, with a 12- and 24-month OS of 47 and 31%. The 12-month progression-free survival was 42% and at 24 months 25%. In addition, 57% of patients showed either an improved or stable neurological function after treatment delivery. Systemic disease progression was the main cause of death. No significant treatment-related toxicities were observed.
RRS appears to be a safe, time-saving and effective treatment modality for intramedullary metastases, especially for patients with unresectable lesions and high burden of disease.
髓内转移瘤罕见，预后不佳。关于此类病变的治疗，可用数据有限。由于手术可能是可切除且局限性转移扩散患者的主要治疗手段，既往病例报告和病例系列提示立体定向放射外科是另一种可行的治疗方式。这项多中心研究分析了机器人立体定向放射外科（RRS）治疗髓内转移瘤的疗效和安全性。
纳入接受RRS治疗至少一处髓内转移瘤的患者。
33例患者共46处髓内转移瘤接受了治疗，中位剂量为16 Gy，中位等剂量线为70%。中位随访8.5个月后，局部控制率为79%。中位总生存期（OS）为11.7个月，12个月和24个月的OS分别为47%和31%。12个月无进展生存期为42%，24个月为25%。此外，57%的患者在治疗后神经功能改善或稳定。全身疾病进展是主要死亡原因。未观察到明显的治疗相关毒性。
RRS似乎是治疗髓内转移瘤的一种安全、省时且有效的治疗方式，尤其适用于不可切除病变和疾病负担重的患者。
