脑转移瘤放射外科的体积调节电弧治疗:一项单中心研究

IF 2.5 4区 综合性期刊 Q2 CHEMISTRY, MULTIDISCIPLINARY
J. M. Sánchez-Villalobos, A. Serna-Berna, J. Salinas-Ramos, P. Escolar-Pérez, Marina Andreu-Gálvez, Emma Martínez-Alonso, J. Pérez-Vicente, Miguel Alcaraz
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引用次数: 0

摘要

全脑放射治疗和立体定向放射外科是治疗脑转移瘤的两种常用治疗方式。本研究的目的是回顾性分析接受体积调制电弧放射外科治疗(VMAT-RS)的骨髓瘤患者队列的主要放射肿瘤学和临床人口学方面。这是一项横断面观察性设计研究,对2012年至2018年间接受VMAT-RS治疗的脑转移患者的医疗记录进行了回顾性审查。分析了临床和人口统计学数据,特别关注性别、年龄、原发性肿瘤、脑肿瘤相关癫痫(BTRE)、骨髓瘤的数量和脑位置、卡诺夫斯基表现状态(KPS)、更新的DS-GPA预后指数以及根据Kaplan–Meier模型自放射外科手术之日起估计的生存率。使用VMAT-RS治疗121例患者,共229例骨髓瘤。患者出现1-4个BMs,用5个非共面VMAT弧进行治疗。68%的患者患有肺癌癌症,35%的BM位于额叶。局部控制的比例为88.5%,BTRE患病率为30.6%,中位生存时间(MST)为7.7个月。在Cox回归模型的多变量分析中,KPS≥70(HRKPS<70=2.59;p=0.001)和较高的DS-GPA(HRDS-GPAI=0.55,p=0.022;HRDS-GPAII-IV=0.38,p=0.006)与生存率的提高有关。在单因素分析中,原发性肿瘤、年龄和后颅窝转移的存在也很显著。总之,VMAT-RS是一种总体生存率与其他放射外科技术相当的技术。KPS和DS-GPA较高者的中位生存期明显较长。其他变量,如原发性肿瘤的类型、年龄和PFBM,也可能影响生存率,尽管还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Volumetric Modulated Arc Therapy for Radiosurgery of Brain Metastases: A Single-Center Study
Whole-brain radiation therapy and stereotactic radiosurgery are two treatment modalities commonly utilized to treat brain metastases (BMs). The aim of this study is to retrospectively analyze the main radio-oncologic and clinical-demographic aspects of a cohort of BM patients treated with Volumetric Modulated Arc Therapy for radiosurgery (VMAT-RS). This is a cross-sectional observational design study with a retrospective review of the medical records of patients with brain metastases treated with VMAT-RS between 2012 and 2018. Clinical and demographic data, with special attention to sex, age, primary tumor, brain tumor-related epilepsy (BTRE), number and brain location of BMs, Karnofsky Performance Status (KPS), the updated DS-GPA prognostic index, and the survival estimated according to the Kaplan–Meier model from the date of radiosurgery, were analyzed. One hundred and twenty-one patients with 229 BMs were treated with VMAT-RS. Patients presented 1–4 BMs, which were treated with five non-coplanar VMAT arcs. Sixty-eight percent of the patients had lung cancer, and 35% of the BMs were in the frontal lobe. The proportion of local control was 88.5%. BTRE prevalence was 30.6%. The median survival time (MST) was 7.7 months. In the multivariate analysis of the Cox regression model, KPS ≥ 70 (HRKPS < 70 = 2.59; p = 0.001) and higher DS-GPA (HRDS-GPAII = 0.55, p = 0.022; HRDS-GPAIII-IV = 0.38, p = 0.006) were associated with improved survival. In the univariate analysis, primary tumor, age, and the presence of metastases in the posterior fossa (PFBMs) were also significant. In conclusion, the VMAT-RS is a technique with an overall survival rate comparable to other radiosurgery techniques. The median survival is significantly longer for those with higher KPS and DS-GPA. Other variables, such as the type of primary tumor, age, and PFBMs, could also influence survival, although further studies are needed.
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来源期刊
Applied Sciences-Basel
Applied Sciences-Basel CHEMISTRY, MULTIDISCIPLINARYMATERIALS SCIE-MATERIALS SCIENCE, MULTIDISCIPLINARY
CiteScore
5.30
自引率
11.10%
发文量
10882
期刊介绍: Applied Sciences (ISSN 2076-3417) provides an advanced forum on all aspects of applied natural sciences. It publishes reviews, research papers and communications. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. Electronic files and software regarding the full details of the calculation or experimental procedure, if unable to be published in a normal way, can be deposited as supplementary electronic material.
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