脑转移癌全脑同期推量IMRT疗效初步分析

doi:10.3760/cma.j.issn.1004-4221.2018.11.001

摘要
图/表
参考文献()
相关文章 (15)
点击分布统计
下载分布统计

全文: PDF (0 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

摘要

目的初步研究全脑同期推量调强放疗(SIB-IMRT)对脑转移癌患者疗效。方法 2016-2017 年收治的52例脑转移癌患者作为观察对象。随机均分为两组,观察组为SIB-IMRT,对照组为常规全脑放疗。初步对比两组疗效。结果两组病患全部顺利完成治疗。观察组客观缓解率明显高于对照组(77%∶27%,P=0.00),中位生存期观察组也长于对照组(384 d∶211 d,P=0.00)。急性不良反应主要为1-2 级反应。结论 SIB-IMRT治疗脑转移癌疗效显著,不良反应可耐受,值得进一步深入研究。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	常娜
	钱立庭
	赵于飞
	葛宁
	周庆
	许友毅
	方金梅
	杨柳

关键词 ：肿瘤转移,脑/全脑同期推量调强放射疗法, 肿瘤转移,脑/全脑放疗, 治疗结果

Abstract：

Objective To preliminary investigate the clinical efficacy of whole brain simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) in patients diagnosed with brain metastases (BM). Methods Fifty-two cases of BM admitted to our hospital from January 2016 to December 2017 were equally recruited and randomly divided into the observation and control groups. Patients in the observation group were treated with SIB-IMRT,and those in the control group received conventional whole brain radiotherapy (WBRT).The clinical efficacy and prognosis were statistically compared between two groups. Results The ORR in the observation group was 77%,significantly higher than 27% in the control group (P=0.00).The median survival in the observation group was 384 d,significantly longer compared with 211 d in the control group (P=0.00).All patients in both groups successfully completed corresponding treatment. Acute adverse reactions were mainly 1-2 grade reactions. Conclusions SIB-IMRT is an efficacious and safe treatment of BM,which yields tolerable adverse events and deserves application in clinical practice.

Key words： Neoplasms metastasis,brain/whole brain simultaneous integrated boost intensity-modulated radiotherapy Neoplasms metastasis,brain/whole brain radiotherapy Treatment outcome

收稿日期: 2018-04-04

通讯作者: 钱立庭,Email:money2004@sina.com

引用本文:

常娜,钱立庭,赵于飞等. 脑转移癌全脑同期推量IMRT疗效初步分析[J]. 中华放射肿瘤学杂志, 2018, 27(11): 955-958.

Chang Na,Qian Liting,Zhao Yufei et al. Preliminary analysis of clinical efficacy of whole brain simultaneous integrated boost intensity-modulated radiotherapy in patients with brain metastases[J]. Chinese Journal of Radiation Oncology, 2018, 27(11): 955-958.

链接本文:

http://journal12.magtechjournal.com/Jweb_fszlx/CN/10.3760/cma.j.issn.1004-4221.2018.11.001 或 http://journal12.magtechjournal.com/Jweb_fszlx/CN/Y2018/V27/I11/955

[1] 殷蔚伯,余子豪,徐国镇,等.肿瘤放疗学[M].4版.北京:中国协和医科大学出版社,2008:1200.
Yin WB, Yu ZH, Xu GZ, et al. Cancer radiotherapy[M].4 ed. Beijing:China union medical university press,2008:1200.
[2] Delattre JY,Krol G,Thaler HT,et al. Distribution of brain metastases[J].Arch Neurol,1988,45(7):741-744.
[3] Sperduto PW,Berkey B,Gaspar LE.A new prognostic index and comparison to three other indices for patients with brain metastases:an analysis of 1,960 patients in the RTOG database[J].Int J Radiat Oncol Biol Phys,2008,70(2):510-514.DOI:10.1016/j.ijrobp.2007.06.074.
[4] Lee YK,Park NH,Kim JW,et al. Gamma-knife radiosurgery as an optimal treatment modality for brain metastases from epithelial ovarian cancer[J].Gynecol Oncol,2008,108(3):505-509.DOI:10.1016/j.ygyno.2007.11.027.
[5] Jeene PM, de Vries KC, van Nes JGH, et al. Survival after whole brain radiotherapy for brain metastases from lung cancer and breast cancer is poor in 6325 Dutch patients treated between 2000 and 2014.Acta Oncol.2018 May;57(5):637-643.DOI:10.1080/0284186X.2017.1418534.
[6] Niravath P,Tham YL,Wang T,et al. A phase Ⅱ trial of capecitabine concomitantly with whole-brain radiotherapy followed by capecitabine and sunitinib for brain metastases from breast cancer.[J].Oncologist,2015,20(1):13.DOI:10.1634/theoncologist.2014-0278.
[7] Shin DY,Na Ⅱ,Kim CH,et al. EGFR,Mutation and Brain Metastasis in Pulmonary Adenocarcinomas[J].J Thorac Oncol,2014,9(2):195-199.DOI:10.1097/JTO.0000000000000069.
[8] Wang TJC,Brown PD.Brain metastases:fractionated whole-brain radiotherapy[M]// Handb Clin Neurol,2018,149:123-127. DOI:10.1016/B978-0-12-811161-1.00009-8.
[9] Brown PD,Ahluwalia MS,Khan OH,et al. Whole-Brain Radiotherapy for Brain Metastases:Evolution or Revolution?[J]. J Clin Oncol,2018,36(5):483-491. DOI:10.1200/JCO.2017.75.9589.
[10] Chua D,Krzakowski M,Chouaid C,et al. Whole-brain radiation therapy plus concomitant temozolomide for the treatment of brain metastases from non-small-cell lung cancer:a randomized,open-label phase Ⅱ study[J].Clin Lung Cancer,2010,11(3):176-181. DOI:10.3816/CLC.2010.n.022.
[11] Xin Y,Guo W,Yang CS,et al. Meta-analysis of whole-brain radiotherapy plus temozolomide compared with whole-brain radiotherapy for the treatment of brain metastases from non-small-cell lung cancer[J].Cancer Med,2018,7(4):981-990. DOI:10.1002/cam4.1306.
[12] 石远凯,孙燕,于金明,等.中国肺癌脑转移诊治专家共识(2017年版)[J].中国肺癌杂志,2017,20(1):1-13. DOI:10.3779/j.issn.1009-3419.2017.01.01.
Shi YK, Sun Y, Yu JM, et al. Consensus of Chinese experts on brain metastasis diagnosis and treatment of lung cancer (2017 edition)[J].Chinese J Lung Cancer, 2007,20(1):1-13. DOI:10.3779/j.issn.1009-3419.2017.01.01.
[13] Jeene PM,De KV,Van JN,et al. Survival after whole brain radiotherapy for brain metastases from lung cancer and breast cancer is poor in 6325 Dutch patients treated between 2000 and 2014[J].Acta Oncol,2017:1-7.DOI:10.1080/0284186X.2017.1418534.
[14] Nieder C,Schwerdtfeger K,Steudel WI,et al. Patterns of relapse and late toxicity after resection and whole-brain radiotherapy for solitary brain metastases[J]. Strahlenther Onkol,1998,174(5):275-278.
[15] Murray L,Menard C,Zadeh G,et al. Radiosurgery for brainstem metastases with and without whole brain radiotherapy:clinical series and literature review[J].J Radiat Oncol,2017,6(1):21-30. DOI:10.1007/s13566-016-0281-4.
[16] Choong NW,Gore E.Stereotactic radiosurgery for the management of brain metastases[J]. N Engl J Med, 2010,362(12):1119-1127. DOI:10.1056/NEJMc1005003.
[17] Dobi A,Fodor E,Maráz A,et al. Boost Irradiation Integrated to Whole Brain Radiotherapy in the Management of Brain Metastases[J].Pathol Oncol Res,2018(1):1-9. DOI:10.1007/s12253-018-0383-y.
[18] 路娜,王雅棣,姚波,等.脑转移癌螺旋断层放疗剂量学特点和近期疗效分析[J].中国实用神经疾病杂志,2014(12):5-7.
Lu N, Wang YD, Yao B,et al. Dosimetry and short-term efficacy of spiral tomography radiotherapy for brain metastases[J].Chin J Pract Neurol, 2014(12):5-7.
[19] 孔琪,陈香存,童铸廷,等.脑转移瘤放疗的剂量学研究[J].实用医学杂志,2018(2):195-198. DOI:10.3969/j.issn.1006-5725.2018.02.008.
Kong Q, Chen XC, Tong ZT, et al. Dosimetry of radiotherapy for brain metastases[J].J Pract Med,2018(2):195-198. DOI:10.3969/j.issn.1006-5725.2018.02.008.
[20] 崔建国,吴星娆,夏群,等.多发性脑转移患者全脑同期推量调强放疗疗效分析[J].河北医学,2014(10):1628-1631. DOI:10.3969/j.issn.1006-6233.2014.10.015.
Cui JG, Wu XR, Xia Q, et al. Effect of whole brain concurrent intensity modulated radiation therapy in patients with multiple brain metastases[J].Hebei Med Uni,2014(10):1628-1631.DOI:10.3969/j.issn.1006-6233.2014.10.015.
[21] 徐海亭,张涛,沈曼曼,等.全脑同期推量调强放疗对颅脑多发性转移癌患者的应用效果[J].实用癌症杂志,2015,30(11):1738-1740. DOI:10.3969/j.issn.1001-5930.2015.11.047.
Xu HT, Zhang T, Shen MM, et al. Effect of whole brain concurrent intensity modulated radiation therapy on patients with multiple brain metastases[J].J Appli Cancer, 2015,30(11):1738-1740.DOI:10.3969/j.issn.1001-5930.2015.11.047.
[22] 蒋爱军,曹欢,章炳蔚,等.伽马刀与IMRT推量技术治疗肺癌脑转移瘤的临床结果分析[J].基层医学论坛,2015(28):3905-3907.
Jiang AJ, Cao H, Zhang BW, et al.[J].Grass-roots Med Forum, 2015(28):305-3907.