Ory Haisraely, Marcia Jaffe, Alisa Taliansky, Zvi R Cohen, Yaakov R Lawerence
{"title":"低分位与标准分位放疗在体弱及老年中枢神经系统孤立性纤维性肿瘤患者中的应用。","authors":"Ory Haisraely, Marcia Jaffe, Alisa Taliansky, Zvi R Cohen, Yaakov R Lawerence","doi":"10.1159/000543847","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Central nervous system solitary fibrous tumors (cSFTs) are rare, accounting for less than 1% of central nervous system tumors. Treatment guidelines are limited, especially for frail or elderly patients. Gross total resection followed by radiotherapy is recommended for higher grade cases, but the role of hypofractionated (HF) radiotherapy versus standard fractionation (SF) in this population remains unclear. This study evaluates outcomes of HF compared to SF in frail patients with cSFT.</p><p><strong>Methods: </strong>A retrospective analysis of 51 frail patients (age >65, Karnofsky performance status [KPS] <80) with cSFT treated from 2015 to 2023 was performed. Patients received either HF (21 patients) or SF (30 patients). Data extracted included demographics, tumor characteristics, surgical outcomes, radiation regimens, and oncologic outcomes. Descriptive and survival analyses were conducted using the Kaplan-Meier methods, with multivariable analysis via Cox regression models to assess factors influencing local control and overall survival.</p><p><strong>Results: </strong>The median follow-up was 19 months (11-55 months). HF regimens varied from 35-48 Gy in 10-15 fractions, while SF was predominantly 54-60 Gy in 28-30 fractions. Local control was achieved in 76.2% of HF and 80% of SF patients (p = 0.154). No statistical difference in overall survival was observed between HF (18 months) and SF (18 months, p = 0.54). Higher tumor grade (HR = 3.5, p = 0.021) and incomplete resection (HR = 0.72, p = 0.035) negatively impacted local control. KPS ≤50 was associated with reduced survival (HR = 2.3, p = 0.035).</p><p><strong>Conclusions: </strong>HF radiotherapy appears feasible and safe for frail patients with cSFT, providing comparable outcomes to SF. The reduced treatment burden of HF may benefit patients with limited performance status. Further research is needed to guide optimal treatment approaches for this unique population. HF vs. SF radiotherapy in frail and elderly patients with cSFTs.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-8"},"PeriodicalIF":2.5000,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Hypo-Fractionated versus Standard Fractionation Radiotherapy in Frail and Elderly Patients with Central Nervous System Solitary Fibrous Tumors.\",\"authors\":\"Ory Haisraely, Marcia Jaffe, Alisa Taliansky, Zvi R Cohen, Yaakov R Lawerence\",\"doi\":\"10.1159/000543847\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Central nervous system solitary fibrous tumors (cSFTs) are rare, accounting for less than 1% of central nervous system tumors. Treatment guidelines are limited, especially for frail or elderly patients. Gross total resection followed by radiotherapy is recommended for higher grade cases, but the role of hypofractionated (HF) radiotherapy versus standard fractionation (SF) in this population remains unclear. This study evaluates outcomes of HF compared to SF in frail patients with cSFT.</p><p><strong>Methods: </strong>A retrospective analysis of 51 frail patients (age >65, Karnofsky performance status [KPS] <80) with cSFT treated from 2015 to 2023 was performed. Patients received either HF (21 patients) or SF (30 patients). Data extracted included demographics, tumor characteristics, surgical outcomes, radiation regimens, and oncologic outcomes. Descriptive and survival analyses were conducted using the Kaplan-Meier methods, with multivariable analysis via Cox regression models to assess factors influencing local control and overall survival.</p><p><strong>Results: </strong>The median follow-up was 19 months (11-55 months). HF regimens varied from 35-48 Gy in 10-15 fractions, while SF was predominantly 54-60 Gy in 28-30 fractions. Local control was achieved in 76.2% of HF and 80% of SF patients (p = 0.154). No statistical difference in overall survival was observed between HF (18 months) and SF (18 months, p = 0.54). Higher tumor grade (HR = 3.5, p = 0.021) and incomplete resection (HR = 0.72, p = 0.035) negatively impacted local control. KPS ≤50 was associated with reduced survival (HR = 2.3, p = 0.035).</p><p><strong>Conclusions: </strong>HF radiotherapy appears feasible and safe for frail patients with cSFT, providing comparable outcomes to SF. The reduced treatment burden of HF may benefit patients with limited performance status. Further research is needed to guide optimal treatment approaches for this unique population. HF vs. SF radiotherapy in frail and elderly patients with cSFTs.</p>\",\"PeriodicalId\":19497,\"journal\":{\"name\":\"Oncology\",\"volume\":\" \",\"pages\":\"1-8\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-02-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000543847\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000543847","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Hypo-Fractionated versus Standard Fractionation Radiotherapy in Frail and Elderly Patients with Central Nervous System Solitary Fibrous Tumors.
Introduction: Central nervous system solitary fibrous tumors (cSFTs) are rare, accounting for less than 1% of central nervous system tumors. Treatment guidelines are limited, especially for frail or elderly patients. Gross total resection followed by radiotherapy is recommended for higher grade cases, but the role of hypofractionated (HF) radiotherapy versus standard fractionation (SF) in this population remains unclear. This study evaluates outcomes of HF compared to SF in frail patients with cSFT.
Methods: A retrospective analysis of 51 frail patients (age >65, Karnofsky performance status [KPS] <80) with cSFT treated from 2015 to 2023 was performed. Patients received either HF (21 patients) or SF (30 patients). Data extracted included demographics, tumor characteristics, surgical outcomes, radiation regimens, and oncologic outcomes. Descriptive and survival analyses were conducted using the Kaplan-Meier methods, with multivariable analysis via Cox regression models to assess factors influencing local control and overall survival.
Results: The median follow-up was 19 months (11-55 months). HF regimens varied from 35-48 Gy in 10-15 fractions, while SF was predominantly 54-60 Gy in 28-30 fractions. Local control was achieved in 76.2% of HF and 80% of SF patients (p = 0.154). No statistical difference in overall survival was observed between HF (18 months) and SF (18 months, p = 0.54). Higher tumor grade (HR = 3.5, p = 0.021) and incomplete resection (HR = 0.72, p = 0.035) negatively impacted local control. KPS ≤50 was associated with reduced survival (HR = 2.3, p = 0.035).
Conclusions: HF radiotherapy appears feasible and safe for frail patients with cSFT, providing comparable outcomes to SF. The reduced treatment burden of HF may benefit patients with limited performance status. Further research is needed to guide optimal treatment approaches for this unique population. HF vs. SF radiotherapy in frail and elderly patients with cSFTs.
期刊介绍：
Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.
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