结直肠癌脑转移瘤的单次SRS与多分次SRT治疗比较研究

doi:10.3760/cma.j.cn113030-20220207-00055

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摘要目的对比多分次立体定向放射治疗(SRT)及单次立体定向放射外科(SRS)治疗结直肠癌脑实质转移瘤的疗效及不良反应。方法检索上海市抗癌协会脑转移瘤专业委员会数据库纳入的结直肠癌脑实质转移瘤患者 98例,其中行SRT者 46例,行SRS者 52例。分析两组患者的临床特征并比较两组的局部肿瘤控制时间、中位生存期、放射性脑损伤发生情况并进行相关因素分析。结果 SRT组与SRS组的肿瘤客观缓解率分别为76.1%与67.3%;两组患者12个月局部肿瘤控制率分别为88.3%和83.9%,无统计学差异(P=0.689);所有患者的中位总生存期为11.6个月,其中SRT组为10.8个月,SRS组为12.7个月,无统计学差异(P=0.129);多因素分析显示患者OS预后不佳的主要因素是:肿瘤数目>3枚(P=0.026)、GPA评分较低(P=0.035)及没有系统治疗模式和贝伐珠单抗应用(P=0.001);两组患者急性和晚期放射性脑损伤的发生率未见明显统计学差异。结论 SRT与SRS均是治疗结直肠脑转移瘤的有效方式,系统治疗模式的协同应用可能是影响患者生存期的主要的原因之一。

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	潘绵顺
	王猛
	李勇
	吴俊兰
	王鹏
	邵显军
	梁晓华
	章菲菲
	沈美华

关键词 ：结直肠肿瘤,脑转移, 立体定向放射治疗, 立体定向放射外科

Abstract：Objective To compare the efficacy and side effects of multi-fraction stereotactic radiotherapy (SRT) and single-fraction stereotactic radiosurgery (SRS) in the treatment of brain metastases from colorectal cancer.Methods A total of 98 patients with brain metastases from colorectal cancer searched from the database of Professional Committee of Brain Metastasis of Shanghai Anticancer Association were recruited in this study. Among them, 46 patients weretreated with SRT and 52 patients with SRS. Clinical characteristics of all patients were analyzed between two groups and the local tumor control rate, median survival time and the incidence of radiation-induced brain injury were compared between two groups. Results The objective remission rates (ORR) in the SRT and SRS groups were 76.1% and 67.3%, respectively. The 12-month local tumor control rates were 88.3% and 83.9% between two groups, with no statistical difference (P=0.689). The median overall survival time of all patients was 11.6 months, 10.8 months in the SRT group and 12.7 months in the SRS group. There was no statistical difference between two groups (P=0.129). Multivariate analysis showed that the main factors leading to poor prognosis included the number of tumors of >3(P=0.026), low GPA score (P=0.035), and lack of systematic treatment mode and bevacizumab (P=0.001). There was no statistical difference in the incidence of acute and late radiation-induced brain injury between two groups. Conclusions Both SRT and SRS are effective therapies for brain metastases from colorectal cancer. The synergistic application of systematic treatment mode may be one of the main reasons affecting the survival time of the patients.

Key words： Colorectal neoplasms,brain metastasis Stereotactic radiotherapy Stereotactic radiosurgery

收稿日期: 2022-02-07

基金资助:结直肠肿瘤智能诊疗系统应用示范(20DZ1100106)

通讯作者: 沈美华,Email:littlelovehouse@126.com

引用本文:

潘绵顺,王猛,李勇等. 结直肠癌脑转移瘤的单次SRS与多分次SRT治疗比较研究[J]. 中华放射肿瘤学杂志, 2022, 31(4): 347-351.

Pan Mianshun,WangMeng,Li Yong et al. Single-fraction SRS and multi-fraction SRT for brain metastases from colorectal cancer[J]. Chinese Journal of Radiation Oncology, 2022, 31(4): 347-351.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.cn113030-20220207-00055 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2022/V31/I4/347

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