Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, 54, Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
Jpn J Radiol. 2022 Oct;40(10):987-994. doi: 10.1007/s11604-022-01333-7. Epub 2022 Sep 3.
The prognosis of patients with brain metastases has dramatically improved, and long-term tumor control and reduction of the risk of late toxicities, including neurocognitive dysfunction, are important for patient quality of life. Stereotactic irradiation for multiple brain metastases, rather than whole-brain radiotherapy, can result in high local control rate with low incidence of neurocognitive deterioration and leukoencephalopathy. Recent advances in radiotherapy devices, treatment-planning systems, and image-guided radiotherapy can realize single isocenter stereotactic irradiation for multiple brain metastases (SI-STI-MBM), in which only one isocenter is sufficient to treat multiple brain metastases simultaneously. SI-STI-MBM has expanded the indications for linear accelerator-based stereotactic irradiation and considerably reduced patient burden. This review summarizes the background, methods, clinical outcomes, and specific consideration points of SI-STI-MBM. In addition, the prospects of SI-STI-MBM are addressed.
脑转移瘤患者的预后有了显著改善，长期肿瘤控制和降低迟发性毒性（包括神经认知功能障碍）的风险对于患者的生活质量非常重要。与全脑放疗相比，立体定向放疗治疗多发脑转移瘤可实现高局部控制率，同时神经认知功能恶化和白质脑病的发生率低。放疗设备、治疗计划系统和图像引导放疗的最新进展可实现多发脑转移瘤的单次等中心立体定向放疗（SI-STI-MBM），其中只需一个等中心即可同时治疗多个脑转移瘤。SI-STI-MBM 扩大了基于直线加速器的立体定向放疗的适应证，并大大减轻了患者的负担。本文总结了 SI-STI-MBM 的背景、方法、临床结果和具体注意要点。此外，还探讨了 SI-STI-MBM 的前景。
