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Choice of radiotherapy modality for the combined treatment of non-small cell lung cancer with brain metastases: whole-brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgery.

作者信息

Dong Xiaotao, Wang Kunlun, Yang Hui, Li Yan, Hou Yanqi, Chang Jiali, Yuan Ling

机构信息

Department of Radiation Oncology Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, Henan, China.

出版信息

Front Oncol. 2023 Sep 22;13:1220047. doi: 10.3389/fonc.2023.1220047. eCollection 2023.


DOI:10.3389/fonc.2023.1220047
PMID:37810984
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10556697/
Abstract

PURPOSE: To compare Whole-brain radiation therapy with simultaneous integrated boost (WBRT+SIB) to stereotactic radiosurgery (SRS)for non-small cell lung cancer (NSCLC)with brain metastases (BMs)in terms of overall survival (OS), intracranial progression-free-survival(iPFS), toxicity and objective response rate (ORR). METHODS: A retrospective review was performed in our hospital of 90 patients diagnosed with NSCLC- BM who received either SRS (n = 48) or WBRT+SIB (n = 42) from January 2016 to January 2022. 76 (84.44%) patients received systemic drug therapy after radiotherapy, including chemotherapy(n=53), targeted therapy(n=40), immunotherapy(n=23), and anti-vascular drug therapy(n=45). OS and iPFS were estimated by the Kaplan-Meier method and compared using the log-rank test. Univariate and Multivariate analysis of the prognostic factors was performed using the Cox proportional hazard regression model. RESULTS: The WBRT+SIB cohort had a longer median iPFS (20.0 versus (VS) 12.0 months, P = 0.0069) and a similar median OS (32.0 vs 28.0 months, P = 0.195) than the SRS cohort. Intracranial objective response rates in WBRT +SIB and SRS cohorts were 76.19% and 70.09%, respectively (P = 0.566). Disease control rates were 88.09% and 83.33%, respectively (P = 0.521). Multivariate analysis showed that WBRT+SIB is the only factor affecting iPFS(hazard ratio (HR):0.597 {95%confidence interval(CI):0.370-0.966}, P=0.035). Sex, Liver metastasis and Lymph node metastasis are risk factors for NSCLC-BM. CONCLUSION: In the context of systemic drug therapy, WBRT+SIB may have better intracranial local control than SRS in NSCLC-BM patients.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f232/10556697/abbd37abd0ba/fonc-13-1220047-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f232/10556697/cdef578333b4/fonc-13-1220047-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f232/10556697/997f2bb3a78f/fonc-13-1220047-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f232/10556697/abbd37abd0ba/fonc-13-1220047-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f232/10556697/cdef578333b4/fonc-13-1220047-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f232/10556697/997f2bb3a78f/fonc-13-1220047-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f232/10556697/abbd37abd0ba/fonc-13-1220047-g003.jpg

相似文献

[1]
Choice of radiotherapy modality for the combined treatment of non-small cell lung cancer with brain metastases: whole-brain radiation therapy with simultaneous integrated boost or stereotactic radiosurgery.

Front Oncol. 2023-9-22

[2]
Real-world analysis of different intracranial radiation therapies in non-small cell lung cancer patients with 1-4 brain metastases.

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[3]
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[4]
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[5]
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[6]
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[10]
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引用本文的文献

[1]
Roles of SPOCK1 in the Formation Mechanisms and Treatment of Non-Small-Cell Lung Cancer and Brain Metastases from Lung Cancer.

Onco Targets Ther. 2025-1-16

[2]
Metastatic brain tumors: from development to cutting-edge treatment.

MedComm (2020). 2024-12-20

[3]
Lymph nodes rather than pleural metabolic activity in F-FDG PET/CT correlates with malignant pleural effusion recurrence in advanced non-small cell lung cancer.

Transl Lung Cancer Res. 2024-9-30

[4]
Outcome of whole brain irradiation with a dose-escalated simultaneous-integrated boost in patients with multiple large and/or diffuse brain metastases: real live data and review of the literature.

Discov Oncol. 2024-8-7

本文引用的文献

[1]
Risk and prognostic factors of brain metastasis in lung cancer patients: a Surveillance, Epidemiology, and End Results population‑based cohort study.

Eur J Cancer Prev. 2023-9-1

[2]
A multidisciplinary management algorithm for brain metastases.

Neurooncol Adv. 2022-11-30

[3]
Navigate Towards the Immunotherapy Era: Value of Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer Patients With Brain Metastases.

Front Immunol. 2022

[4]
Immunotherapy in association with stereotactic radiotherapy for non-small cell lung cancer brain metastases: results from a multicentric retrospective study on behalf of AIRO.

Neuro Oncol. 2021-10-1

[5]
Epidemiology of brain metastases and leptomeningeal disease.

Neuro Oncol. 2021-9-1

[6]
Upfront pembrolizumab as an effective treatment start in patients with PD-L1 ≥ 50% non-oncogene addicted non-small cell lung cancer and asymptomatic brain metastases: an exploratory analysis.

Clin Transl Oncol. 2021-9

[7]
Randomised prospective phase II trial in multiple brain metastases comparing outcomes between hippocampal avoidance whole brain radiotherapy with or without simultaneous integrated boost: HA-SIB-WBRT study protocol.

BMC Cancer. 2020-10-30

[8]
Brain metastases of lung cancer: comparison of survival outcomes among whole brain radiotherapy, whole brain radiotherapy with consecutive boost, and simultaneous integrated boost.

J Cancer Res Clin Oncol. 2021-2

[9]
Hippocampus-avoidance whole-brain radiation therapy with a simultaneous integrated boost for multiple brain metastases.

Cancer. 2020-6-1

[10]
Outcomes of whole-brain radiation with simultaneous in-field boost (SIB) for the treatment of brain metastases.

J Neurooncol. 2020-1-22

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