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引用次数: 0
摘要
运动皮层脑转移瘤的治疗具有挑战性。迄今为止,手术切除或立体定向放射手术(SRS)/低分次立体定向放射治疗(hypoSRT)是有价值的选择。由于其独特的位置和潜在的神经功能缺损,这两种治疗方法都不能令人完全满意。关于运动皮层转移的治疗效果,目前仍缺乏相关数据。本研究对手术和 SRS/hypoSRT 治疗运动皮层脑转移瘤进行了全面回顾和荟萃分析。研究人员在PubMed、Embase和Cochrane图书馆等核心数据库中对运动皮层脑转移进行了系统检索,结果显示了手术和SRS/hypoSRT的临床疗效。对运动能力结果和治疗相关并发症发生率进行了全面评估。25篇文章被列入全文综述。其中13篇符合纳入标准:比较手术和SRS/hypoSRT的回顾性队列研究。手术组有 323 名患者,SRS/hypoSRT 组有 220 名患者。手术组的运动结果更好,但无统计学意义(0.49 vs 0.37,P = 0.3937),手术组的治疗相关并发症更低,有统计学意义(0.09 vs 0.26,P = 0.0218)。治疗方式应根据患者的表现状况、放射治疗史、是否正在接受化疗或颅外进展状况来确定。
Surgical resection versus stereotactic radiosurgery for the treatment of brain metastases in the motor cortex; a meta-analysis and systematic review.
Brain metastasis in the motor cortex is a challenging condition to treat. Surgical resection or stereotactic radiosurgery (SRS)/hypofractionated stereotactic radiotherapy (hypoSRT) are valuable options up to now. Due to its unique location and potential for neurologic deficits, neither treatment is entirely satisfactory. There is still a lack of data on the treatment result of motor cortex metastasis. This study provides a comprehensive review and meta-analysis comparing surgery and SRS/hypoSRT for treating brain metastasis in the motor cortex. Core databases, including PubMed, Embase, and the Cochrane Library, were systematically searched for brain metastasis in the motor cortex, demonstrating the clinical outcomes of both surgery and SRS/hypoSRT. Motor power outcome and treatment-associated complication rates were thoroughly evaluated. Twenty-five articles were listed for full-text review. Among them, 13 articles were eligible for inclusion criteria: retrospective cohort studies comparing surgery and SRS/hypoSRT. There are 323 patients in the surgery group and 220 in the SRS/hypoSRT group. The motor outcome is better in surgery group, but without statistical significance (0.49 vs 0.37, p = 0.3937) and treatment-related complication is lower in surgery group with statistical significance (0.09 vs 0.26, p = 0.0218). Treatment modality should be tailored by the patient's performance status, history of radiation, presence of ongoing chemotherapy, or extracranial progression status.
期刊介绍:
The Journal''s scope encompasses all aspects of metastasis research, whether laboratory-based, experimental or clinical and therapeutic. It covers such areas as molecular biology, pharmacology, tumor biology, and clinical cancer treatment (with all its subdivisions of surgery, chemotherapy and radio-therapy as well as pathology and epidemiology) insofar as these disciplines are concerned with the Journal''s core subject of metastasis formation, prevention and treatment.