Frisk Gabriella, Helde Frankling Maria, Warnqvist Anna, Björkhem-Bergman Linda, Hedman Mattias
Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, 141 83 Huddinge, Sweden.
ASIH Stockholm Södra, Palliative Home Care and Specialized Palliative Ward, 125 59 Älvsjö, Sweden.
Life (Basel). 2022 Apr 1;12(4):525. doi: 10.3390/life12040525.
Whole-brain radiotherapy (WBRT) as a treatment for brain metastases has been questioned over the last years. This study aimed to evaluate health care levels and survival after WBRT in a cohort of lung cancer patients with brain metastases receiving WBRT in Stockholm, Sweden, from 2008 to 2019 ( = 384). If the patients were able to come home again was estimated using logistic regression and odds ratios (OR) and survival by using Cox regression. The median age in the cohort was 65.6 years, the median survival following WBRT was 2.4 months (interquartile range (IQR) 1.2-6.2 months), and 84 (22%) patients were not able to come home after treatment. Significantly more males could come home again after WBRT compared to women (OR = 0.37, 95%CI 0.20-0.68). Patients with performance status scores WHO 3-4 had a median survival of 1.0 months, hazard ratio (HR) = 4.69 (95%CI 3.31-6.64) versus WHO score 0-1. Patients admitted to a palliative ward before WBRT had a median survival of 0.85 months, HR = 2.26 (95%CI 1.53-3.34) versus being at home. In conclusion, patients treated with WBRT had a short median survival and 20% could not be discharged from the hospital following treatment. Significantly more women did not come home again.
在过去几年中，全脑放疗（WBRT）作为脑转移瘤的一种治疗方法一直备受质疑。本研究旨在评估2008年至2019年在瑞典斯德哥尔摩接受WBRT的一组肺癌脑转移患者接受WBRT后的医疗保健水平和生存率（n = 384）。使用逻辑回归和比值比（OR）估计患者是否能够再次回家，并使用Cox回归分析生存率。该队列的中位年龄为65.6岁，WBRT后的中位生存期为2.4个月（四分位间距（IQR）为1.2 - 6.2个月），84名（22%）患者在治疗后无法回家。与女性相比，接受WBRT后能够再次回家的男性明显更多（OR = 0.37，95%CI 0.20 - 0.68）。世界卫生组织（WHO）功能状态评分为3 - 4分的患者中位生存期为1.0个月，风险比（HR）= 4.69（95%CI 3.31 - 6.64），而WHO评分为0 - 1分的患者为对照。在WBRT前入住姑息病房的患者中位生存期为0.85个月，HR = 2.26（95%CI 1.53 - 3.34），而在家中的患者为对照。总之，接受WBRT治疗的患者中位生存期较短，20%的患者在治疗后无法出院。女性不能再次回家的比例明显更高。
