立体定向放射外科治疗妇科恶性肿瘤脑转移：回顾性治疗结果分析。

Stereotactic radiosurgery for brain metastases arising from gynecological malignancies: A retrospective treatment outcome analysis.

作者信息

Shopen Yoni, Blumenfeld Philip, Grinshpun Albert, Krakow Aron, Wygoda Marc, Shoshan Yigal, Popovtzer Aron, Falick Michaeli Tal

机构信息

Department of Radiation Oncology, Sharett Institute of Oncology, Hebrew University Medical Center, Jerusalem, Israel.

出版信息

J Clin Neurosci. 2024 Mar;121:89-96. doi: 10.1016/j.jocn.2024.02.018. Epub 2024 Feb 19.

DOI:10.1016/j.jocn.2024.02.018

PMID:38377883

Abstract

BACKGROUND

This retrospective study aims to assess the efficacy of stereotactic radiosurgery (SRS) in the treatment of brain metastases (BM) originating from gynecological cancers. It focuses on local control (LC), distant tumor control (DTC), and overall survival (OS).

METHODS

The analysis comprised 18 individuals with gynecological-origin BM treated with SRS at the Hadassah Medical Center from 2004 to 2021. Statistical analyses evaluate factors impacting LC, DTC, and OS.

RESULTS

A total of 36 BM of gynecological origin underwent SRS. The median age at the first SRS treatment was 60 years, with a median time of 24.5 months from the primary malignancy diagnosis to BM detection. The 12-month LC rate per patient was 84.6 %, and 5.6 % per BM. Only two instances of local recurrence were observed. The DTC at 12 months was 75 %, with a 29 % overall. Non-significant trends indicating a correlation with distant brain failure with increased cumulative volume and the occurrence of craniotomy before SRS. The median OS of the cohort was 16.5 months from SRS treatment. The 6, 12, 18, and 24-month survival rates were 77.8 %, 66.7 %, 50 %, and 22.2 % respectively. Higher number of BM was associated with lower OS (p = 0.046). On multivariate analysis, age was a significant factor for OS (p = 0.03), demonstrating that older age was associated with a more favorable prognosis.

CONCLUSION

This study supports SRS effectiveness for treating BM from gynecological cancers and suggests similar outcomes to more common malignancies.

摘要

背景

本回顾性研究旨在评估立体定向放射外科（SRS）治疗源自妇科癌症的脑转移瘤（BM）的疗效。研究重点在于局部控制（LC）、远处肿瘤控制（DTC）和总生存期（OS）。

方法

分析包括2004年至2021年在哈达萨医疗中心接受SRS治疗的18例源自妇科的BM患者。统计分析评估影响LC、DTC和OS的因素。

结果

共有36例源自妇科的BM接受了SRS治疗。首次SRS治疗时的中位年龄为60岁，从原发性恶性肿瘤诊断到BM检测的中位时间为24.5个月。每位患者的12个月LC率为84.6%，每个BM为5.6%。仅观察到2例局部复发。12个月时的DTC为75%，总体为29%。有非显著趋势表明，随着累积体积增加和SRS前开颅手术的发生，与远处脑衰竭相关。该队列从SRS治疗开始的中位OS为16.5个月。6、12、18和24个月的生存率分别为77.8%、66.7%、50%和22.2%。BM数量较多与较低的OS相关（p = 0.046）。多因素分析显示，年龄是OS的显著因素（p = 0.03），表明年龄较大与更有利的预后相关。