Primary Stereotactic Body Radiotherapy for Spinal Bone Metastases From Lung Adenocarcinoma

IF 4.3 3区材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC

ACS Applied Electronic Materials Pub Date : 2024-05-25 DOI:10.1016/j.cllc.2024.05.007

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Abstract

Objective

This study aimed to assess the results of primary stereotactic body radiotherapy (SBRT) for spinal bone metastases (SBM) originating from lung adenocarcinoma (ADC). We considered the revised Tokuhashi score (rTS), Spinal Instability Neoplastic Score (SINS), and genetic characteristics.

Methods

We examined adult patients with lung ADC who underwent primary SBRT (using the CyberKnife System) for SBM between March 2012 and January 2023.

Results

We analyzed data from 99 patients, covering 152 SBM across 194 vertebrae. The overall local control (LC) rate was 77.6% for SBM from lung ADC, with a LC rate of 90.7% at 1 year. The median period for local progression (LP) occurrence was recorded at 10.0 (3-52) months. Additionally, Asian patients demonstrated higher LC rates than White patients. Utilizing the rTS and SINS as predictive tools, we revealed that a poor survival prognosis and an unstable spinal structure were associated with increased rates of LP. Furthermore, the presence of osteolytic bone destructions and pain complaints were significantly correlated with the occurrence of LP. In the cohort of this study, 108 SBM underwent analysis to determine the expression levels of programmed cell death ligand 1 (PD-L1). Additionally, within this group, 60 showed mutations in the epidermal growth factor receptor (EGFR) alongside PD-L1 expression. Nevertheless, these genetic differences did not result in statistically significant differences in the LC rate.

Conclusion

The one-year LC rate for primary SBRT targeting SBM from lung ADC stood at 90.7%, particularly with the use of the CyberKnife System. Patients achieving LC exhibited significantly longer survival times compared to those with LP.

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肺腺癌脊柱骨转移的原发性立体定向体放射治疗

研究目的本研究旨在评估原发性立体定向体放射治疗（SBRT）治疗肺腺癌（ADC）脊柱骨转移瘤（SBM）的效果。我们考虑了修订版德桥评分（rTS）、脊柱不稳定性肿瘤评分（SINS）和遗传特征：我们研究了 2012 年 3 月至 2023 年 1 月间接受 SBRT（使用 CyberKnife 系统）治疗 SBM 的肺 ADC 成年患者：我们分析了99例患者的数据，涉及194个椎体的152例SBM。肺部ADC的SBM总体局部控制率（LC）为77.6%，1年后的LC率为90.7%。局部进展（LP）发生的中位时间为 10.0（3-52）个月。此外，亚裔患者的 LC 率高于白人患者。利用 rTS 和 SINS 作为预测工具，我们发现生存预后差和脊柱结构不稳定与 LP 发生率增加有关。此外，溶骨性骨质破坏和疼痛主诉的存在与 LP 的发生有显著相关性。在这项研究的队列中，有108例SBM接受了分析，以确定程序性细胞死亡配体1（PD-L1）的表达水平。此外，在这组患者中，有 60 人在 PD-L1 表达的同时，表皮生长因子受体（EGFR）也出现了突变。尽管如此，这些基因差异并未导致 LC 率出现统计学意义上的显著差异：结论：以肺部 ADC 的 SBM 为靶点的初级 SBRT 一年生存率为 90.7%，尤其是在使用 CyberKnife 系统的情况下。与LP患者相比，获得LC的患者生存时间明显更长。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

ACS Applied Electronic Materials Multiple-

CiteScore

7.20

自引率

4.30%

发文量

567