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立体定向体部放疗(SBRT)治疗妇科癌症淋巴结转移寡转移患者的临床疗效

Clinical Outcomes of Stereotactic Body Radiotherapy (SBRT) for Oligometastatic Patients with Lymph Node Metastases from Gynecological Cancers.

作者信息

Facondo Giuseppe, Vullo Gianluca, De Sanctis Vitaliana, Rotondi Margherita, Sigillo Riccardo Carlo, Valeriani Maurizio, Osti Mattia Falchetto

机构信息

Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, 00189 Rome, Italy.

出版信息

J Pers Med. 2023 Jan 27;13(2):229. doi: 10.3390/jpm13020229.

Abstract

BACKGROUND

To evaluate clinical outcomes of stereotactic body radiation therapy (SBRT) as a local treatment for lymph node metastases from gynecological cancers.

METHODS

Between November 2007 and October 2021, we retrospectively analyzed 29 lymph node metastases in 22 oligometastatic/oligoprogressive patients treated with SBRT. The Kaplan-Meier method was used to estimate the rates survival. Univariate analysis for prognostic factors were performed with the log-rank test, and Cox proportional hazards regression was used to estimate hazard ratios (HR).

RESULTS

Median age was 62 years (IQR, 50-80 years). Median follow-up was 17 months (IQR 10.5-31 months). The median survival was 22 months (CI 95%: 4.2-39.7, IQR: 12.5-34.5 months). Six months, one year and two year overall survival (OS) were 96.6%, 85.2%, and 48.7%, respectively. Median local control (LC) was not reached. Six months, 1one year and 2 year were 93.1%, 87.9%, and 79.9%, respectively. Distant metastasis free survival (DMFS) at one year, and two year was 53% and 37.1%, respectively Four patients (18%) experienced acute G1-G2 toxicities. No G3-4 acute toxicity was reported, and no late toxicity was observed.

CONCLUSIONS

SBRT for lymph node recurrence offers excellent in-field tumor control with safe profile and low toxicities. Size, number of oligometastases, and time primary tumor to RT seem to be significant prognostic factors.

摘要

背景

评估立体定向体部放射治疗(SBRT)作为妇科癌症淋巴结转移局部治疗的临床疗效。

方法

2007年11月至2021年10月期间,我们回顾性分析了22例接受SBRT治疗的寡转移/寡进展患者的29处淋巴结转移情况。采用Kaplan-Meier法估计生存率。用对数秩检验对预后因素进行单因素分析,并用Cox比例风险回归估计风险比(HR)。

结果

中位年龄为62岁(四分位间距,50 - 80岁)。中位随访时间为17个月(四分位间距10.5 - 31个月)。中位生存期为22个月(95%置信区间:4.2 - 39.7,四分位间距:12.5 - 34.5个月)。6个月、1年和2年的总生存率(OS)分别为96.6%、85.2%和48.7%。中位局部控制(LC)未达到。6个月、1年和2年分别为93.1%、87.9%和79.9%。1年和2年的无远处转移生存期(DMFS)分别为53%和37.1%。4例患者(18%)出现1 - 2级急性毒性反应。未报告3 - 4级急性毒性反应,也未观察到晚期毒性反应。

结论

SBRT治疗淋巴结复发可实现良好的靶区内肿瘤控制,安全性好且毒性低。寡转移灶的大小、数量以及原发肿瘤至放疗的时间似乎是重要的预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f980/9965700/e81f11fe7c14/jpm-13-00229-g001.jpg

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