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首页> 美国卫生研究院文献>Molecular and Clinical Oncology >Comparison between stereotactic radiosurgery and whole-brain radiotherapy for 10-20 brain metastases from non-small cell lung cancer
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Comparison between stereotactic radiosurgery and whole-brain radiotherapy for 10-20 brain metastases from non-small cell lung cancer

机译：立体定向放射外科与全脑放射治疗非小细胞肺癌10-20例脑转移的比较

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The efficacy and safety of stereotactic radiosurgery (SRS) in comparison with whole brain radiotherapy (WBRT) for brain metastases (BMs) remains unclear. The present study retrospectively reviewed 44 patients who received SRS or WBRT as an initial treatment for 10–20 BMs from non-small cell lung cancer between 2009 and 2016. Of the patients, 24 (54.5%) were treated with SRS and 20 (45.5%) were treated with WBRT. Overall survival (OS), time to intracranial progression (TTIP), neurological survival (NS), and prognostic factors were examined. OS did not significantly differ between the two groups: 7.3 months in the SRS group vs. 7.2 months in the WBRT group (P=0.502). Median TTIP was significantly shorter in the SRS group than in the WBRT group (7.1 vs. 19.1 months, P=0.009). In contrast, there were no significant differences in NS between the two groups (14.5 months in the SRS group vs. 12.9 months in the WBRT group, P=0.346). Univariate and multivariate analysis revealed that the type of initial treatment for BMs (WBRT or SRS) was not a significant prognostic factor (hazard ratio=0.80, 95% confidence interval: 0.42–1.52, P=0.502). However, histology, performance status, subsequent molecular targeted drugs, subsequent chemotherapy and salvage treatment were independent prognostic factors. There were no significant differences in OS and NS between treatment with SRS and treatment with WBRT in patients with 10–20 BMs, although TTIP was improved with WBRT. As an upfront treatment for 10–20 BMs, SRS may delay WBRT and the adverse events associated with WBRT.
机译：与全脑放疗（WBRT）相比，立体定向放射外科（SRS）在脑转移瘤（BMs）方面的疗效和安全性尚不清楚。本研究回顾性回顾了2009年至2016年间接受SRS或WBRT作为非小细胞肺癌10-20 BMs初始治疗的44例患者。其中24例（54.5％）接受SRS治疗，20例（45.5） ％）用WBRT处理。检查了总生存期（OS），颅内进展时间（TTIP），神经学生存期（NS）和预后因素。两组之间的OS无显着差异：SRS组为7.3个月，而WBRT组为7.2个月（P = 0.502）。 SRS组的中位TTIP明显短于WBRT组（7.1比19.1个月，P = 0.009）。相比之下，两组之间的NS差异无统计学意义（SRS组为14.5个月，WBRT组为12.9个月，P = 0.346）。单因素和多因素分析显示，BMs的初始治疗类型（WBRT或SRS）不是重要的预后因素（危险比= 0.80，95％置信区间：0.42-1.52，P = 0.502）。然而，组织学，表现状态，随后的分子靶向药物，随后的化学疗法和挽救性治疗是独立的预后因素。尽管WBRT改善了TTIP，但在10-20 BMs患者中，SRS治疗和WBRT治疗之间的OS和NS没有显着差异。作为10到20个BM的前期治疗，SRS可能会延迟WBRT和与WBRT相关的不良事件。

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