全脑放疗联合或不联合同期整合推量治疗脑转移瘤。

Whole-brain Radiotherapy With or Without a Simultaneous Integrated Boost for Treatment of Brain Metastases.

机构信息

Department of Radiation Oncology, University of Lübeck, Lübeck, Germany;

Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.

出版信息

Anticancer Res. 2023 Jul;43(7):3107-3112. doi: 10.21873/anticanres.16482.

DOI:10.21873/anticanres.16482

PMID:37351983

Abstract

BACKGROUND/AIM: Many patients with brain metastases receive whole-brain radiotherapy (WBRT), despite the increasing use of stereotactic radiotherapy alone. A more recent approach includes WBRT combined with simultaneous integrated boost (WBRT+SIB). This study compared WBRT alone and WBRT+SIB for unresected brain metastases.

PATIENTS AND METHODS

One-hundred-and-three patients receiving WBRT+SIB were compared to 275 patients receiving WBRT alone for intracerebral control (IC) and overall survival (OS).

RESULTS

Both treatment groups (WBRT alone and WBRT+SIB) were balanced with respect to patient characteristics. On multivariate analyses, WBRT+SIB (p=0.041), Karnofsky performance score (KPS) >70 (p<0.001), and 1-3 brain metastases (p=0.016) were significantly associated with IC. KPS >70 (p<0.001), favorable tumor type (p=0.011), 1-3 brain metastases (p=0.011), and absence of extracranial metastases (p<0.001) were significantly associated with OS.

CONCLUSION

WBRT+SIB is associated with improved IC but similar OS when directly compared to WBRT for brain metastases. Selected patients with a high risk of intracerebral recurrence may benefit from SIB.

摘要

背景/目的：许多脑转移患者接受全脑放疗（WBRT），尽管立体定向放疗的应用日益增加。最近的一种方法包括 WBRT 联合同步整合增敏放疗（WBRT+SIB）。本研究比较了未切除脑转移患者中单独接受 WBRT 和 WBRT+SIB 的疗效。

患者和方法

将 103 例接受 WBRT+SIB 的患者与 275 例单独接受 WBRT 的患者进行比较，以评估颅内控制（IC）和总生存（OS）。

结果

两组患者（单独接受 WBRT 和 WBRT+SIB）在患者特征方面具有可比性。多因素分析显示，WBRT+SIB（p=0.041）、Karnofsky 表现评分（KPS）>70（p<0.001）和 1-3 个脑转移灶（p=0.016）与 IC 显著相关。KPS>70（p<0.001）、有利的肿瘤类型（p=0.011）、1-3 个脑转移灶（p=0.011）和无颅外转移（p<0.001）与 OS 显著相关。