A comparative analysis of SRT and SRS in the treatment of brain metastases from lung adenocarcinoma

中华放射肿瘤学杂志 Pub Date : 2020-02-15 DOI:10.3760/CMA.J.ISSN.1004-4221.2020.02.002

Yong Li, Fenghua Liu, Kangning Liang, Xianjun Shao, Li Zhang, Xiaohua Liang, Mianshun Pan

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Abstract

Objective To compare the clinical efficacy of stereotactic radiotherapy (SRT) and stereotactic radiosurgery (SRS) in the treatment of brain metastases from January 2006 to December 2016, lung adenocarcinoma and analyze the related factors. Methods In this multi-center retrospective analysis, clinical data of 208 patients with brain metastases from lung adenocarcinoma were retrospectively analyzed and assigned into the SRT (n=86) and SRS groups (n=122). The clinical characteristics of patients in two groups were analyzed. The local tumor control rate, median survival time and radiation brain injury were statistically compared between two groups. Results At the end of follow-up, the objective response rates (ORR) were 70.9% and 71.3% in the SRT and SRS groups (P=0.772). The local tumor control rates at 12 months were 89% and 86% in the SRT and SRS groups (P=0.383). The median overall survival time of all patients was 14.3 months, 15.6 months in the SRT group and 13.7 months in the SRS group (P=0.349). Multivariate analysis showed that large target volume (P<0.001), low GPA score (P=0.012) and no insensitive gene mutation (P<0.001) were the main factors of poor prognosis. The incidence of late radiation brain injury was 5.8% and 14.8% in two groups (P=0.043). Conclusions SRT and SRS yield similar clinical efficacy in the treatment of brain metastases from lung adenocarcinoma. SRT may have a lower incidence of late radiation brain injury than SRS. Key words: Brain metastasis/lung neoplasms; Stereotactic radiotherapy; Stereotactic radiosurgery

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SRT和SRS治疗肺腺癌脑转移的对比分析

目的比较2006年1月至2016年12月立体定向放疗(SRT)与立体定向放射手术(SRS)治疗脑转移性肺腺癌的临床疗效，并分析相关因素。方法对208例肺腺癌脑转移患者的临床资料进行回顾性分析，分为SRT组(n=86)和SRS组(n=122)。分析两组患者的临床特点。对两组局部肿瘤控制率、中位生存时间及放射性脑损伤进行统计学比较。结果随访结束时，SRT组和SRS组的客观有效率(ORR)分别为70.9%和71.3% (P=0.772)。SRT组和SRS组12个月局部肿瘤控制率分别为89%和86% (P=0.383)。所有患者的中位总生存时间为14.3个月，SRT组为15.6个月，SRS组为13.7个月(P=0.349)。多因素分析显示，靶体积大(P<0.001)、GPA评分低(P=0.012)、无不敏感基因突变(P<0.001)是导致预后不良的主要因素。两组晚期放射性脑损伤发生率分别为5.8%和14.8% (P=0.043)。结论SRT与SRS治疗肺腺癌脑转移的临床疗效相近。SRT可能比SRS有更低的晚期放射性脑损伤发生率。关键词:脑转移/肺肿瘤;立体定向放射治疗;立体定向放射治疗

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来源期刊

中华放射肿瘤学杂志

自引率

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发文量

6375

期刊介绍： The Chinese Journal of Radiation Oncology is a national academic journal sponsored by the Chinese Medical Association. It was founded in 1992 and the title was written by Chen Minzhang, the former Minister of Health. Its predecessor was the Chinese Journal of Radiation Oncology, which was founded in 1987. The journal is an authoritative journal in the field of radiation oncology in my country. It focuses on clinical tumor radiotherapy, tumor radiation physics, tumor radiation biology, and thermal therapy. Its main readers are middle and senior clinical doctors and scientific researchers. It is now a monthly journal with a large 16-page format and 80 pages of text. For many years, it has adhered to the principle of combining theory with practice and combining improvement with popularization. It now has columns such as monographs, head and neck tumors (monographs), chest tumors (monographs), abdominal tumors (monographs), physics, technology, biology (monographs), reviews, and investigations and research.