脑转移患者立体定向放疗联合同步全脑放疗的回顾性研究。

Retrospective study of hypofractionated stereotactic radiotherapy combined with whole brain radiotherapy for patients with brain metastases.

机构信息

Department of Oncology, The Third Xiangya Hospital of Central South University, Changsha, People's Republic of China.

出版信息

Radiat Oncol. 2022 Jul 26;17(1):132. doi: 10.1186/s13014-022-02096-1.

DOI:10.1186/s13014-022-02096-1

PMID:35883147

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9327356/

Abstract

BACKGROUND AND PURPOSE

To evaluate the clinical outcomes of hypofractionated stereotactic radiotherapy (HFSRT) combined with whole brain radiotherapy (WBRT) in patients with brain metastases (BMs).

MATERIALS AND METHODS

From May 2018 to July 2020, 50 patients (111 lesions) received HFSRT (18 Gy/3F) + WBRT (40 Gy/20F). The RECIST 1.1 and RANO-BM criteria were used to evaluate treatment efficacy. Five prognostic indexes (RPA, GPA, SIR, BS-BM, and GGS) were applied. The primary endpoint was intracranial local control (iLC). Secondary endpoints were overall survival (OS) and the safety of treatment.

RESULTS

Intracranial objective response rates (iORR) using the RECIST 1.1 and RANO-BM criteria were 62.1% and 58.6%, respectively. The iLC rate was 93.1%, the 6- and 12-month iLC rates were 90.8% and 57.4%, respectively. The median intracranial progression-free survival (iPFS) was not reached (range 0-23 months). The 6-, 12-, and 24-month OS rates were 74.2%, 58.2%, and 22.9%, respectively. The KPS score showed statistical significance in univariate analysis of survival. The 6, 12, and 24 month OS rates for patients with KPS ≥ 70 were 83.8%, 70.5%, and 29.7%, respectively. The median survival time (MST) for all patients and for patients with KPS ≥ 70 were 13.6 and 16.5 months, respectively. Sex, KPS score, and gross tumor volume were significant factors in the multivariate analysis of survival. OS was significantly associated with RPA, SIR, BS-BM, and GGS classes. No acute toxicities of grade 3 or higher were noted.

CONCLUSION

HFSRT combined with WBRT is a safe and effective local treatment modality for BM patients.

摘要

背景与目的

评估立体定向放疗（HFSRT）联合全脑放疗（WBRT）治疗脑转移瘤（BM）患者的临床疗效。

材料与方法

2018 年 5 月至 2020 年 7 月，50 例（111 个病灶）患者接受 HFSRT（18 Gy/3F）+WBRT（40 Gy/20F）治疗。采用 RECIST 1.1 标准和 RANO-BM 标准评价治疗效果。应用 5 种预后指标（RPA、GPA、SIR、BS-BM 和 GGS）。主要终点为颅内局部控制率（iLC）。次要终点包括总生存（OS）和治疗安全性。

结果

采用 RECIST 1.1 标准和 RANO-BM 标准评价的颅内客观缓解率（iORR）分别为 62.1%和 58.6%。iLC 率为 93.1%，6 个月和 12 个月 iLC 率分别为 90.8%和 57.4%。中位颅内无进展生存期（iPFS）未达到（范围 0-23 个月）。6 个月、12 个月和 24 个月 OS 率分别为 74.2%、58.2%和 22.9%。KPS 评分在单因素生存分析中具有统计学意义。KPS≥70 分患者的 6、12 和 24 个月 OS 率分别为 83.8%、70.5%和 29.7%。所有患者和 KPS≥70 分患者的中位生存时间（MST）分别为 13.6 个月和 16.5 个月。性别、KPS 评分和肿瘤总体积是影响生存的多因素分析中的显著因素。OS 与 RPA、SIR、BS-BM 和 GGS 分级显著相关。未观察到 3 级或以上的急性毒性反应。