Fractionated stereotactic radiotherapy of brain metastases from renal cell carcinoma
Fractionated stereotactic radiotherapy of brain metastases from renal cell carcinoma
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DOI：
10.1016/s0360-3016(00)00804-x
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发表时间：
2000-12-01
影响因子：
7
通讯作者：
Nomura, K
中科院分区：
文献类型：
--
作者：
Ikushima, H;Tokuuye, K;Nomura, K
目的：方法：1983年5月至1998年9月，35例肾细胞癌脑转移瘤患者在东京国立癌症中心医院接受了放射治疗，10例患者接受了FSRT治疗，10例患者接受了FSRT治疗。单纯手术组（FSRT组）11例，单纯手术+放疗组（S/CR组）11例，单纯放疗组（CR组）14例。结果：全组中位生存率为18个月，1年和2年生存率分别为57.6%和31.0%。FSRT组的中位生存率为25.6个月，S/CR组为18.7个月，CR组为4.3个月。与生存率相关的重要预后因素是年龄小于60岁和良好的体能状态。在接受FSRT治疗的患者中，影像学研究显示，在中位随访时间5.2个月（范围0.5-68）内，24个肿瘤中有21个（88%）得到局部控制。精算1年和2年局部控制率分别为89.6%和55.2%。无患者发生急性或晚期并发症期间和以下FSRT。结论：FSRT提供了更好的肿瘤控制和S/CR或CR组的生存期延长，并应被视为从RCC脑转移瘤的主要治疗。60岁以下患者和放疗开始时体能状态良好者预后较好。(C)2000 Elsevier Science Inc.
Purpose: To retrospectively evaluate the effectiveness of fractionated stereotactic radiotherapy (FSRT) for brain metastases from renal cell carcinoma (RCC).Methods and Materials: From May 1983 to September 1998, 35 patients with brain metastases from RCC underwent radiotherapy at the National Cancer Center Hospital, Tokyo; 10 patients treated initially with FSRT (FSRT group); 11 with surgery followed by conventional radiotherapy (S/CR group); and 14 with conventional radiotherapy (CR group). Survival and local control rates were determined for patients who had an ECOG performance status of 0-2.Results: Overall median survival rate was 18 months, and actuarial 1- and 2-year survival rates were 57.6% and 31.0%, respectively. Median survival rates were 25.6 months for the FSRT group, 18.7 months for the S/CR group, and 4.3 months for the CR group. Significant prognostic factors associated with survival were age less than 60 years and good performance status. In patients treated with FSRT, imaging studies revealed that 21 of 24 tumors (88%) were locally controlled during a median follow-up time of 5.2 months (range 0.5-68). Actuarial 1- and 2-year local control rates were 89.6% and 55.2%, respectively. No patient suffered from acute or late complications during and following FSRT.Conclusions: FSRT offers better tumor control and prolonged survival over the S/CR or CR groups, and should be considered as primary treatment for brain metastases from RCC. Patients under 60-years-old and those with a good performance status at the beginning of radiotherapy had a better prognosis. (C) 2000 Elsevier Science Inc.