立体定向放射治疗食管癌脑转移后的局部控制和患者生存:一项国际多中心分析。

IF 3.5 2区 医学 Q1 CLINICAL NEUROLOGY
Othman Bin-Alamer, Hussam Abou-Al-Shaar, Raj Singh, Greg Bowden, David Mathieu, Haley K Perlow, Joshua D Palmer, Shahed Elhamdani, Matthew Shepard, Yun Liang, Ahmed M Nabeel, Wael A Reda, Sameh R Tawadros, Khaled Abdel Karim, Amr M N El-Shehaby, Reem Emad Eldin, Ahmed Hesham Elazzazi, Ronald E Warnick, Yair M Gozal, Megan Daly, Brendan McShane, Marcel Addis-Jackson, Gokul Karthikeyan, Sian Smith, Piero Picozzi, Andrea Franzini, Tehila Kaisman-Elbaz, Huai-Che Yang, Judith Hess, Kelsey Templeton, Zhishuo Wei, Stylianos Pikis, Georgios Mantziaris, Gabriela Simonova, Roman Liscak, Selcuk Peker, Yavuz Samanci, Veronica Chiang, Cheng-Chia Lee, Daniel M Trifiletti, Ajay Niranjan, L Dade Lunsford, Jason P Sheehan
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引用次数: 0

摘要

目的:本研究旨在评估食管癌脑转移瘤(EBMs)的肿瘤局部控制(LC)、患者总生存期(OS)和立体定向放射手术(SRS)的安全性。方法:这项回顾性队列研究使用了来自15个国际放射外科研究基金会机构的数据,包括2000年1月至2022年5月期间使用SRS管理的67例185例EBMs患者。患者中位年龄为63岁,男性居多(92.5%)。大多数患者(64.2%)有单一脑转移,而7.5%的患者有5个以上的转移。肿瘤中位体积0.9 cm3,给瘤中位切缘剂量20 Gy。结果:srs后的中位OS为15.2个月,1年和2年OS率分别为65.7%和32.3%。在单变量分析中发现EBMs数量与OS之间存在显著的负相关。1年和2年的LC率分别为89%和76%。17.9%的患者观察到不良辐射效应(AREs),其中13.4%为轻度和短暂性症状,4.5%为严重症状(不良事件通用术语标准3级)。58.2%的患者出现新的颅内疾病,1年和2年的发生率分别为58%和73%。结论:SRS治疗EBMs生存率高,肿瘤得到有效控制,严重AREs发生率低。这些发现强调了SRS在循证医学多学科多模式管理范式中的潜在作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Local control and patient survival after stereotactic radiosurgery for esophageal cancer brain metastases: an international multicenter analysis.

Objective: This study aimed to evaluate local control (LC) of tumors, patient overall survival (OS), and the safety of stereotactic radiosurgery (SRS) for esophageal cancer brain metastases (EBMs).

Methods: This retrospective cohort study used data from 15 International Radiosurgery Research Foundation facilities encompassing 67 patients with 185 EBMs managed using SRS between January 2000 and May 2022. The median patient age was 63 years, with a male predominance (92.5%). Most patients (64.2%) had a single brain metastasis, while 7.5% had more than 5 metastases. The median tumor volume was 0.9 cm3, and the median margin dose delivered to the tumor was 20 Gy.

Results: The median OS post-SRS was 15.2 months, with 1- and 2-year OS rates of 65.7% and 32.3%, respectively. A significant inverse correlation was found between the number of EBMs and OS in the univariable analysis. LC rates at 1 and 2 years were 89% and 76%, respectively. Adverse radiation effects (AREs) were observed in 17.9% of patients, with 13.4% being mild and transient and 4.5% severely symptomatic (Common Terminology Criteria for Adverse Events grade 3). New intracranial disease developed in 58.2% of patients, with 1- and 2-year rates of 58% and 73%, respectively.

Conclusions: SRS for EBMs demonstrated high survival rates and effective tumor control, with a low incidence of severe AREs. These findings highlight the potential role of SRS in the multidisciplinary multimodality management paradigm of EBM.

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来源期刊
Journal of neurosurgery
Journal of neurosurgery 医学-临床神经学
CiteScore
7.20
自引率
7.30%
发文量
1003
审稿时长
1 months
期刊介绍: The Journal of Neurosurgery, Journal of Neurosurgery: Spine, Journal of Neurosurgery: Pediatrics, and Neurosurgical Focus are devoted to the publication of original works relating primarily to neurosurgery, including studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology. The Editors and Editorial Boards encourage submission of clinical and laboratory studies. Other manuscripts accepted for review include technical notes on instruments or equipment that are innovative or useful to clinicians and researchers in the field of neuroscience; papers describing unusual cases; manuscripts on historical persons or events related to neurosurgery; and in Neurosurgical Focus, occasional reviews. Letters to the Editor commenting on articles recently published in the Journal of Neurosurgery, Journal of Neurosurgery: Spine, and Journal of Neurosurgery: Pediatrics are welcome.
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