Mereniuk Todd R, Burney Heather N, Lautenschlaeger Tim, Watson Gordon A, Rhome Ryan M
Department of Radiation Oncology, Indiana School of Medicine, Indianapolis, IN 46202, USA.
Department of Biostatistics, Indiana School of Medicine, Indianapolis, IN 46202, USA.
J Radiosurg SBRT. 2022;8(3):189-199.
To determine factors associated with increased risk of finding new and/or enlarged brain metastases (BM) on GammaKnife™ (GK) MRI and their impact on patient outcomes.
43.9% of patients showed BM growth, 32.9% had additional brain metastases (aBM), and 18.1 % had both. Initial brain metastasis velocity (iBMV) was associated with finding aBM. Time between diagnostic MRI (dMRI) and GK MRI was associated with interval growth and each day increased this risk by 2%. Prior brain metastasectomy and greater time between either dMRI or latest extracranial RT and GK MRI predicted both aBM and BM growth. aBM and/or BM growth led to management change in 1.8% of cases and were not associated with OS or incidence of distant intracranial failure.
Number of metastases seen on dMRI and iBMV predicted both aBM and/or BM growth, however, these factors did not significantly affect survival or incidence of distant intracranial failure.
确定与伽玛刀(GK)磁共振成像(MRI)发现新的和/或增大的脑转移瘤(BM)风险增加相关的因素及其对患者预后的影响。
43.9%的患者出现BM生长,32.9%有额外的脑转移瘤(aBM),18.1%两者皆有。初始脑转移瘤速度(iBMV)与发现aBM相关。诊断性MRI(dMRI)与GK MRI之间的时间与间隔期生长相关,且每天此风险增加2%。既往脑转移瘤切除术以及dMRI或最近一次颅外放疗与GK MRI之间更长的时间可预测aBM和BM生长。aBM和/或BM生长导致1.8%的病例治疗改变,且与总生存期(OS)或远处颅内失败发生率无关。
dMRI上可见的转移瘤数量和iBMV可预测aBM和/或BM生长,然而,这些因素并未显著影响生存期或远处颅内失败发生率。