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全脑放疗联合同步整合加量放疗(SIB-WBRT)治疗肺癌脑转移的疗效

Efficacy of Whole-Brain Radiotherapy Plus Simultaneous Integrated Boost (SIB-WBRT) for Lung Cancer Brain Metastases.

作者信息

Bi Qian, Shen Jing, Li Pengyu, Zeng Yuhao, Lian Xin, Zhang Fuquan

机构信息

Department of Radiation Oncology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Department of General Surgery, Peking Union Medical College Hospital (PUMCH), Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.

出版信息

J Cancer. 2024 Jul 2;15(14):4636-4642. doi: 10.7150/jca.95804. eCollection 2024.

Abstract

To investigate the outcomes of SIB-WBRT in patients with brain metastases and analyze the impact of some factors on prognosis. This single-arm retrospective study analyzed patients with brain metastases who were treated with SIB-WBRT at Peking Union Medical College Hospital from September 2015 to December 2021. The primary endpoint was intracranial progression free survival (iPFS). Secondary endpoints included overall survival (OS), intracranial new foci, and tumor control. The Kaplan-Meier method was then used to depict and estimate iPFS, OS, intracranial neoplasia, and tumor control. Finally, the Cox model was used to analyze the association between some relevant factors and outcomes. A total of 107 patients were included and the median iPFS in these patients treated with SIB-WBRT was 13.4 (95% CI: 4.2-22.6) months, with 68.0% (95% CI: 57.4%-78.6%) and 50.8% (95% CI: 38.3%-63.3%) iPFS at 6- and 12-months. The median local control was 37.6 (95% CI: 28.3-46.8) months, with local control rates of 84.3% (95% CI: 80.6%-88.0%) and 73.3% (95% CI: 68.2%-78.4%) at 6- and 12-months. The median time to appearance of new intracranial foci was 17.4 (95% CI: 14.1-20.8) months, and the 6- and 12-month control rates were 74.5% (95% CI: 64.5%-84.5%) and 61.5% (95% CI: 49.0%-74.0%). The number of brain metastases in patients before treatment was significantly associated with iPFS (HR=0.4, 95% CI: 0.2-0.973, =0.043). The iPFS, local control, and intracranial new foci of patients with brain metastases after treatment with SIB-WBRT were acceptable. In addition, the number of brain metastases in patients before treatment may be associated with iPFS.

摘要

探讨立体定向体部放疗(SIB-WBRT)治疗脑转移瘤患者的疗效,并分析某些因素对预后的影响。本单臂回顾性研究分析了2015年9月至2021年12月在北京协和医院接受SIB-WBRT治疗的脑转移瘤患者。主要终点是颅内无进展生存期(iPFS)。次要终点包括总生存期(OS)、颅内新病灶和肿瘤控制情况。然后采用Kaplan-Meier方法描述和估计iPFS、OS、颅内肿瘤形成和肿瘤控制情况。最后,使用Cox模型分析一些相关因素与预后之间的关联。共纳入107例患者,接受SIB-WBRT治疗的这些患者的中位iPFS为13.4(95%CI:4.2-22.6)个月,6个月和12个月时的iPFS分别为68.0%(95%CI:57.4%-78.6%)和50.8%(95%CI:38.3%-63.3%)。中位局部控制时间为37.6(95%CI:28.3-46.8)个月,6个月和12个月时的局部控制率分别为84.3%(95%CI:80.6%-88.0%)和73.3%(95%CI:68.2%-78.4%)。颅内新病灶出现的中位时间为17.4(95%CI:14.1-20.8)个月,6个月和12个月时的控制率分别为74.5%(95%CI:64.5%-84.5%)和61.5%(95%CI:49.0%-74.0%)。治疗前患者脑转移瘤的数量与iPFS显著相关(HR=0.4,95%CI:0.2-0.973,P=0.043)。SIB-WBRT治疗后脑转移瘤患者的iPFS、局部控制和颅内新病灶情况是可以接受的。此外,治疗前患者脑转移瘤的数量可能与iPFS有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08a8/11242338/0010df5485dc/jcav15p4636g001.jpg

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