脑转移瘤:全脑放射治疗是否仍有作用?

IF 2.6 3区 医学 Q3 ONCOLOGY
Carsten Nieder MD , Nicolaus H. Andratschke MD , Anca L. Grosu MD
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引用次数: 2

摘要

全脑放射治疗(WBRT)通常被用来缓解脑转移的症状,降低手术切除后局部复发的风险,并在切除或放射外科手术后改善远处大脑的控制。虽然靶向整个大脑的微转移可以被认为是有利的,但同时暴露于健康的脑组织可能会导致不良事件。减轻WBRT后神经认知能力下降风险的尝试包括选择性避开海马等。除了选择性减少剂量外,增加剂量以提高体积,例如同时综合增强,旨在提高肿瘤控制概率在技术上是可行的。虽然新诊断的脑转移瘤的早期放射治疗通常只针对可见病变采用放射外科或其他技术,但WBRT的顺序(延迟)挽救治疗可能仍然是必要的。此外,软脑膜肿瘤或非常广泛的脑实质转移的存在可能促使临床医生开具早期WBRT处方。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Brain Metastases: Is There Still a Role for Whole-Brain Radiation Therapy?

Whole-brain radiation therapy (WBRT) has commonly been prescribed to palliate symptoms from brain metastases, to reduce the risk of local relapse after surgical resection, and to improve distant brain control after resection or radiosurgery. While targeting micrometastases throughout the brain can be considered advantageous, the simultaneous exposure of healthy brain tissue might cause adverse events. Attempts to mitigate the risk of neurocognitive decline after WBRT include the selective avoidance of the hippocampi, among others. Besides selective dose reduction, dose escalation to boost volumes, for example, simultaneous integrated boost, aiming at increased tumor control probability is technically feasible. While up-front radiotherapy for newly diagnosed brain metastases often employs radiosurgery or other techniques targeting visible lesions only, sequential (delayed) salvage treatment with WBRT might still become necessary. In addition, the presence of leptomeningeal tumors or very widespread parenchymatous brain metastases might prompt clinicians to prescribe early WBRT.

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来源期刊
CiteScore
5.80
自引率
0.00%
发文量
48
审稿时长
>12 weeks
期刊介绍: Each issue of Seminars in Radiation Oncology is compiled by a guest editor to address a specific topic in the specialty, presenting definitive information on areas of rapid change and development. A significant number of articles report new scientific information. Topics covered include tumor biology, diagnosis, medical and surgical management of the patient, and new technologies.
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