164例颅外寡转移放疗疗效及预后分析

doi:10.3760/cma.j.issn.1004-4221.2018.07.010

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摘要

目的分析颅外寡转移患者的放疗疗效及影响生存的预后因素。方法 2013-2016年不同肿瘤来源及转移部位的164例接受IMRT的颅外寡转移患者纳入研究,观察近期疗效、局部控制率(LC)、总生存(OS)、无进展生存(PFS)及治疗的不良反应。结果治疗结束后1~3个月观察近期疗效,客观缓解率(CR+PR)为78.7%,近期疗效主要与原发肿瘤T分期有关(P=0.004)。截至最后1次随访,全组患者1、2、3年LC分别为89.8%、82.5%、74.9%,单因素分析显示影响LC的因素为转移灶大小和肿瘤靶区剂量(均P<0.05),多因素分析未发现明显影响因素;1、2、3年OS分别为83.4%、69.6%和54.6%,单因素及多因素分析显示原发肿瘤来源、转移器官部位、是否同步或辅助化疗及近期疗效是影响患者OS的独立预后因素(均P<0.05)。不良反应主要为1-2级急性反应,其中6例为3级不良反应,无4级及以上和死亡病例发生。结论颅外寡转移放疗可以取得较好疗效,且具有较好的耐受性及低的不良反应。

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	张献文
	张慧慧
	徐洪波
	周咏春
	汪庚明
	周燕
	蔡丰
	江浩

关键词 ：肿瘤寡转移, 颅外寡转移, 肿瘤/放射疗法, 预后

Abstract：

Objective To investigate theefficacy of radiotherapy,as well as the prognostic factors of survival in patients with extracranial oligometastases. Methods A total of 164 patients who underwent intensity-modulated radiotherapy (IMRT) of the extracranial oligometastases, from January 2013 to December 2016,were enrolled in the study. The short-term efficacy,local control rate,overall survival,progression free survival and adverse effects of treatment were observed. Results Short-term efficacy was assessed within the first 1-3 months after the end of radiotherapy. The objective response rate (CR+PR) was 78.7% and the short-term efficacy is mainly related to the T stage of primary tumor (P=0.004).Until the last follow-up,all patientswith 1-,2- and 3-year LCwere 89.8%,82.5% and 74.9% respectively. Univariate analysis showed that the influencing factors of LC include tumor size and gross tumor volume dose (all P<0.05),multivariate analysis found no significant influence factors.The 1-,2- and 3-year OSwere 83.4%,69.6% and 54.6% respectively. Univariate and multivariate analysis showed that the primary tumor sources,metastasis organs,whether synchronous or adjuvant chemotherapy and short-term efficacy were independent prognostic factors in patients of OS (P<0.05).Main toxicity-associated events were grade 1-2 acute reactions,with only 6 patients experiencing grade 3 toxicity;no grade ≥ 4 toxic reactions or treatment-related deaths occurred.Conclusions Radiation therapy for the treatment of extracranial oligometastases can achieve good curative effect,is well-tolerated and has low toxicity.

Key words： Neoplasms oligometastases Extracranial oligometastases Neoplasms/radiotherapy Prognosis

收稿日期: 2017-08-25

基金资助:

安徽省“十二五”临床医学重点专科建设基金(01Z33)

通讯作者: 江浩, Email:jianghao1223@163.com

引用本文:

张献文,张慧慧,徐洪波等. 164例颅外寡转移放疗疗效及预后分析[J]. 中华放射肿瘤学杂志, 2018, 27(7): 669-674.

Zhang Xianwen,Zhang Huihui,Xu Hongbo et al. Analysis of radiotherapy curative effect and prognostic factors in 164 patients with extracranial oligometastases[J]. Chinese Journal of Radiation Oncology, 2018, 27(7): 669-674.

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http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2018.07.010 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2018/V27/I7/669

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