现代磁共振成像时代可省略对局限期小细胞肺癌的预防性头颅照射:倾向评分匹配分析。

IF 1.9 4区 医学 Q2 BIOLOGY
Kei Ito, Yujiro Nakajima, Shota Minakami, Yumiko Machitori, Yukio Hosomi, Kana Hashimoto, Makoto Saito, Keiko Nemoto Murofushi
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引用次数: 0

摘要

我们的目的是澄清在当前磁共振成像(MRI)时代,预防性头颅照射(PCI)是否与有限期小细胞肺癌(LS-SCLC)的预后改善有关。研究人员回顾性研究了两家医疗中心的LS-SCLC患者数据,这些患者对明确的化放疗(CRT)取得了完全反应。按照2:1的比例进行倾向评分匹配,以平衡无PCI组和PCI组的基线特征。研究终点为脑转移(BM)发生率、神经系统死亡原因和总生存率(OS)。总体而言,80%的患者在初始分期时接受了头部磁共振成像检查,75名患者(无PCI组,n = 50;PCI组,n = 25)进行了配对。除年龄外,他们的基线特征基本均衡;无PCI组患者年龄偏大。中位随访时间为 29 个月。虽然无 PCI 组的 BM 发生率更高(1 年 BM 发生率:26% vs 17%,P = 0.22),但两组间多发性 BM(定义为大于 4 个转移灶)的发生率相似(1 年多发性 BM 发生率:8% vs 9%,P = 0.65)。两组患者的2年神经系统死因和OS率无明显差异(分别为6%和9%;P = 0.85;70%和79%;P = 0.36)。如果将现代成像模式纳入初始诊断,即使不进行 PCI,1 年多发性 BM 的发生率也不会增加,这表明如果将 MRI 纳入初始诊断和随访,CRT 后可以省略 PCI。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prophylactic cranial irradiation for limited-stage small-cell lung cancer in the modern magnetic resonance imaging era may be omitted: a propensity score-matched analysis.

We aimed to clarify whether prophylactic cranial irradiation (PCI) is associated with improved outcomes in limited-stage small-cell lung cancer (LS-SCLC) in the current era of magnetic resonance imaging (MRI). Data from patients with LS-SCLC who achieved a complete response to definitive chemoradiotherapy (CRT) at two medical centers were retrospectively reviewed. Propensity score-matching was performed in a 2:1 ratio to balance the baseline characteristics of the no-PCI and PCI groups. The endpoints were the incidence of brain metastasis (BM), neurological causes of death and overall survival (OS). Overall, 80% patients underwent head MRI during the initial staging and 75 patients (no-PCI, n = 50; PCI, n = 25) were matched. Their baseline characteristics were generally well-balanced except for age; patients in the no-PCI group tended to be older. The median follow-up period was 29 months. Although the incidence of BMs tended to be higher in the no-PCI group (1-year BM occurrence: 26% vs 17%, P = 0.22), the incidence of multiple BMs (defined as >4 metastases) was similar between groups (1-year multiple BMs occurrence: 8% vs 9%, P = 0.65). The 2-year neurological causes of death and OS rate did not significantly differ between the groups (6% and 9%; P = 0.85; and 70% and 79%; P = 0.36, respectively). The 1-year occurrence of multiple BMs did not increase, even without PCI, when modern imaging modalities were integrated into the initial diagnosis, suggesting that PCI could be omitted after CRT, if MRI was incorporated into the initial diagnosis and follow-up.

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来源期刊
CiteScore
3.60
自引率
5.00%
发文量
86
审稿时长
4-8 weeks
期刊介绍: The Journal of Radiation Research (JRR) is an official journal of The Japanese Radiation Research Society (JRRS), and the Japanese Society for Radiation Oncology (JASTRO). Since its launch in 1960 as the official journal of the JRRS, the journal has published scientific articles in radiation science in biology, chemistry, physics, epidemiology, and environmental sciences. JRR broadened its scope to include oncology in 2009, when JASTRO partnered with the JRRS to publish the journal. Articles considered fall into two broad categories: Oncology & Medicine - including all aspects of research with patients that impacts on the treatment of cancer using radiation. Papers which cover related radiation therapies, radiation dosimetry, and those describing the basis for treatment methods including techniques, are also welcomed. Clinical case reports are not acceptable. Radiation Research - basic science studies of radiation effects on livings in the area of physics, chemistry, biology, epidemiology and environmental sciences. Please be advised that JRR does not accept any papers of pure physics or chemistry. The journal is bimonthly, and is edited and published by the JRR Editorial Committee.
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